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PCR London Valves 2021 - LOCAL POD APPLICATION FORM
Thank you for considering organising a Local Pod at PCR London Valves 2021.
1.
Podmaster Name:
The Podmaster can be a physician, an institution, a hospital group, a local or a national society
Name of the Podmaster
Hospital / Company / Institution
Email Adress
2.
Pod name:
As it should appear in the PCR London Valves 2021 platform (for chat, comments, and questions)
3.
Pod Location
Pod City
Pod Location / Venue
4.
Expected participants
Number of expected participants
Speciality
Average years of experience
5.
The pod is an opportunity for self-directed learning. Could you please explain in a few words the educational objectives you wish to achieve with your Pod participants?
6.
Would you be willing to receive some scientific assignments from the PCR London Valves Board (for example evaluating some sessions)?
YES
NO
Comments
7.
Will you be partnering with a local Industry partner for the organisation your Pod?
YES
NO
Comments
8.
If yes, please mention the company name:
9.
Please confirm that you can commit to ensure that all participants attending the Pod will be officially registered to PCR London Valves 2021 and join the PCR Companion programme?
YES
NO
Comments
10.
Do you need some extra Industry support (funding) to register participants?
YES
NO
Comments
