europeanstrokeconference regular form

ESC ongoing trials form

There will be no review process for “Ongoing Trials” and it will be published a few days after submitting on our website!
Ongoing Trials will be accepted exclusively for poster presentations!
Deadline 15 May 2010!

Follow the fields carefully.
Obligatory information is indicated by stars ( * ) coloured in red.

Submitting Person:

*Password: (Please use 5-20 letters) *Date: (mm.dd.jjjj)

*First names (initials only: example A.A.): *Last name:

*Street: *Number:

*Zipcode: *City:

*Country:

*E-mail:
It is important that you enter your e-mail address accurately! Please inform us about any changes immediately!

*Phone: *Fax:

Abstract Details:

*Presentation

*Subject area/Topic:

*Abstract title

Max. 200 characters/signs, including blanks!

*Abstract text

Max. 2000 characters/signs, including blanks!
Tables and graphics/figures are to be submitted separately after successful abstract submission via email including the AID.
Avoid complex mathematical formulae. For the plus minus symbols, type +/- instead of ±
Avoid Greek letters and symbols, e.g. 'IFN-g' or 'IFN-gamma'.

Trialists:

*1. Presenting Author

*Mrs./Mr.: *Academic title: *Age:
*First names (initials only: example A.A.): *Last name:
*Institution:
*City: *Country:

*E-mail presenting auhtor:
It is important that you enter your e-mail address accurately! Please inform us about any changes immediately!

2. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

3. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

4. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

5. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

6. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

7. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

8. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

9. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

10. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

11. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

12. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

13. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

14. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

15. Co-Author:
First names (initials only: example A.A.): Last name:
Institution:
City: Country:

General Information:

*Hereby I confirm, that this abstract has not been published before!

* Copyright transfer to Karger Pub, Switzerland in case of acceptance is agreed

*Conflict of interests will be disclosed!

Please check your data carefully before submission!