Title (required)

Type of Course (required)
live, in person (with or without recorded presentations available online after the course)hybrid (combination of live and synchronous online access)virtual only (online, with or without recorded presentations available online after the course)*

Aims of teaching course (required)

Course Location, City, Venue (required)

Dates and duration (required)

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Course Director (required)

Course Director email (required)

Brief CV of the Course Director (required)

Anticipated attendance (for each type attendee) (required)

Preliminary program (required)

Desired outcomes (required)

Suggestions for IPNA regional speakers (required)

Suggestions for IPNA international speakers (required)

Are CME Credits provided (yes or no)? (required)
yesno

Registration fees for participants (in US$)

Detailed incomes and expenses (in US$) (required)

Sponsors (required)

Requested amount of IPNA contribution (required)

Please indicate any local specific issues in particular travel, safety and health issues

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