CEME Scientific Research Poster Competition

CEME's Student/Intern/Resident/Fellow Scientific Research Poster Competition is open to students, interns, residents and fellows who are training at NSUCOM or in a CEME-affiliated program.
The Poster Competition is held in Don Taft University Center at Nova Southeastern University main campus in Davie, FL.
Click here for map of the campus (locate the Don Taft University Center) .

Please fill out the application and submit it by clicking "SUBMIT APPLICATION FORM" button at the bottom of this screen. You will receive a confirmation email sent to the "First Author's Email" that you enter on this form. Entries received after the deadline will not be accepted.

Note: All fields are required.

Campus: Fort Lauderdale Tampa Bay

Poster Category: CASE STUDY EXPERIMENTAL RESEARCH

Note - your abstract and poster will be judged by different criteria depending on the research type.

Poster Title:
(no surrounding quotation characters)

Characters remaining (max. 240): 240

First Author:

First Author's Hospital/
Institution and Program Name:

First Author's
Email Address:

First Author's
Phone:

First Author's Year of Training:

OMS-#

OGME-#

Fellow

List all additional authors - include for each their title, department, and institution:

Name	OMS#, OGME#, Fellow or Physician	Hospital/Institution	Department/Program

Was this research funded by some agency?
No
Yes (If "Yes", please list below)

IRB approval has been:
Received
Not Applicable (If "Not Applicable", why not? Please explain below)

Upload the ABSTRACT of your poster/presentation (MsWord only):

Proprietary Statement/Disclosure

I certify that I have no affiliation/financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the abstract or presentation.

I certify that I have an affiliation/financial involvement with:

which has a direct financial interest in the subject matter/materials discussed in the abstract or presentation.

Approval to attend - place a check next to one of the statements corresponding to you:

I am a Resident or a Fellow. I have the approval/permission from my Program Director.
I am M3 or M4. I have the approval/permission from my DME.
I am M1 or M2. I have the permission from the assistant dean of student services.

Signatures

Checking this checkbox is in lieu of the signatures of ALL AUTHORS, verifying that all authors significantly participated in the research product. This is required for the form to be submitted.

Please review this form before submitting.