Details of Presenting Author

(Presenting Author is the person who would present the paper to conference, if it were to be selected as a spoken presentation.)

Title: Mr Ms Dr Mrs Miss Prof    First Name:    Last Name:

Correspondence Address:    

Address Line 1:  Address Line 2:
Address Line 3:        Postal City :
Postcode          :                                      Country   :
Phone                :                                       Fax           :      
e-mail                 : A valid e-mail address is required!

Details of abstract

Title:
          Remember to use sensible formatting. NOT LIKE THIS (Turn off your Caps Lock key)!

Category (choose one):                   Clinical genetics/ counselling    
                                                                Molecular genetics                        
                                                                Cytogenetics             

Abstracts offered for spoken presentation may be accepted as posters and vice versa, unless you indicate that this is unacceptable to you. (Final decisions will be made by the Abstracts Review Committee.)

Abstract offered as:

Spoken Presentation (but will present as Poster, if offered)

Spoken Presentation ONLY (will not present as Poster)

Poster (but will present as Spoken, if offered)

Poster ONLY (will not present as Spoken)

Clinical Genetics SpR's Poster Competition  
If you are a Specialist Registrar in Clinical Genetics, and wish to enter your POSTER submission
for this competition, please tick here:

Keywords. You may suggest up to four keywords, to help indexing in the Abstracts booklet:

 Abstract Text: 

Authors and Institutions

Presenting Author's Institution (This author's name should already be entered above): 1 2 3 4 5 6
Choose a number from the list, and fill in the details of the institution in the Institutions List below.

Other Authors:
            Last Name            Initials  Institution            Last Name              Initials  Institution

2:           1 2 3 4 5 6         9:            1 2 3 4 5 6

3:           1 2 3 4 5 6       10:            1 2 3 4 5 6

4:           1 2 3 4 5 6       11:            1 2 3 4 5 6

5:           1 2 3 4 5 6       12:            1 2 3 4 5 6

6:           1 2 3 4 5 6       13:            1 2 3 4 5 6

7:           1 2 3 4 5 6       14:            1 2 3 4 5 6

8:           1 2 3 4 5 6       15:            1 2 3 4 5 6

16: Institutional Authors:
                                                (for example: Huntington Disease Consortium)

Institutions List - for each number used above, give the details of the Institution:

1:     4:

2:     5:

3:     6:

When you have completed the form, go back to the top, and check it carefully.

Once you are happy that it is correct, click the Submit Form button, just ONCE:

If you have made a mess of the form, and would like to clear all the boxes and start again,

click the Reset Form button: