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!
Title: Remember to use sensible formatting. NOT LIKE THIS (Turn off your Caps Lock key)!
Category (choose one): Clinical genetics/ counselling Molecular genetics Cytogenetics Social Policy and Education
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:
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:
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