S F A SAMPLE

The 1st Asian Congress of Abdominal Radiology
Phoenix Seagaia Resort, Miyazaki, Japan June 1(Fri.) – 2(Sat.), 2007
【SAMPLE】
】ABSTRACT SUBMITTING FORM
Call for Paper …………… October 12, 2006
Final Abstract Deadline……
…… February 1, 2007
Submitting Procedure
1. This form should be filled out by a presenter and please click gray boxes to do so.
2. Please save this form as the presenter’s name. (Ex. “Jane P. Smith.doc”)
3. Please attach the form to your e-mail and send it to [email protected]
4. Once we receive your abstract, we will send a confirmation to the presenter by e-mail.
Please note that submitting your abstract will not be completed without our
confirmation mail. In case you do not hear from us within a week, please contact us
regarding your abstract. Our contact information is at the bottom of this page.
Please type only in ENGLISH.
Ⅰ. PRESENTER’S GENERAL INFORMATION
Ms.
Name & Affiliation
First Name: John
Middle Initial: P.
Mr.
Dr.
Prof.
Last Name: Seidel
Title/Position: President of XXX Medical Center
Affiliation: Department of Interventional Radiology, XXX University Faculty of Medicine
Mailing Address
Street: 3-19-3 Toyosaki, Kita-Ku
Province/State: Osaka
City: Osaka City
Country: Japan
Postal/Zip Code: 531-0072
Contact Address
Tel: +81-6-6377-2188
Fax: +81-6-6377-2075
E-mail Address: [email protected]
Secretariat of The 1st Asian Congress of Abdominal Radiology
C/o Convention Linkage, Inc.
PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku, Osaka, 531-0072 Japan
Tel: +81-6-6377-2188 Fax: +81-6-6377-2075
E-mail: [email protected]
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The 1st Asian Congress of Abdominal Radiology
Phoenix Seagaia Resort, Miyazaki, Japan June 1(Fri.) – 2(Sat.), 2007
Ⅱ. CO-AUTHORS
First
Middle
Name
1.
Asami
3.
Cristina
2.
Initial
Maria
4.
F.
C.
Last
Name
Fukui
Borrajo
Magnolia
Affiliation
Country
XXXX University Faculty of Medicine
Japan
XXXX University of Medicine
Philippines
XXXX Center
USA
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Ⅲ. SCIENTIFIC TOPICS
(Please specify topics of your abstract.)
Diagnostic Imagings
- Gastrointestinal Neoplasms
- Hepatobiliary and Pancreas
- Portal Venous System
- Peritoneum and Mesenteries
- Genitourinary Tracts
- Retroperitoneum
- Others (
Less Invasive Therapy / Interventional Radiology
- Image-guided Treatment for Abdominal Neoplasms
- Transarterial Treatment for Abdominal Neoplasms
- Stenting of Gastrointestinal Tract
- Vascular Interventional Radiology
- Others (
)
)
Secretariat of The 1st Asian Congress of Abdominal Radiology
C/o Convention Linkage, Inc.
PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku, Osaka, 531-0072 Japan
Tel: +81-6-6377-2188 Fax: +81-6-6377-2075
E-mail: [email protected]
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The 1st Asian Congress of Abdominal Radiology
Phoenix Seagaia Resort, Miyazaki, Japan June 1(Fri.) – 2(Sat.), 2007
Please type only in ENGLISH.
Ⅳ. ABSTRACT
Please let us know which type of presentation you would like to make for this abstract. Please also
understand that you might be asked to change it after we have accepted your abstract.
Presentation type: Oral
/
Poster
*Please Note: In order to use full function of Word’s system, for instance “auto character counting”,
“symbols” and “particular characters”, please create your abstract on another Word file first, not on
this form, then copy and paste it onto this form.
Title (within 20 words) Title title title title title title title title title title
Abstract (within 250 words)
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Abstract Body Abstract Body.
Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body
Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body
Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body
Abstract Body Abstract Body Abstract Body Abstract Body.
Abstract Body Abstract Body Abstract Body Abstract Body.
Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body.
Before you send this file to us,
-Please save this file in your PC first.
-File name should be your name. (Ex. Jane P. Smith.doc).
-Please make sure to send this file to [email protected] by February 1,
2007 (Japan time). We DO NOT accept after this date.
Correction: In case you need to make changes, please fill out this form again and submit it to the
conference secretariat below.
Thank you very much for your cooperation.
Secretariat of The 1st Asian Congress of Abdominal Radiology
C/o Convention Linkage, Inc.
PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku, Osaka, 531-0072 Japan
Tel: +81-6-6377-2188 Fax: +81-6-6377-2075
E-mail: [email protected]