Personal Details

Title:

Ms

Mrs

Mr

Dr

other

If other, please specify:

Family Name:*

First Name:*

Institution:*

Telephone:*

Mobile:

Fax:*

Email address:*

Mailing Address:*

Post Code:*

Country:*

Tick if a Joint Presentation.

If you are submitting a joint presentation, please enter the second (and third) speaker's details here:

Family Name:

First Name:

Family Name:

First Name:

Presentation Details

Title of Presentation:*

Type and length of Presentation:

Talk (45 minutes)

Commercial Presentation (45 minutes)

Workshop (45 minutes)

Workshop (90 minutes)

If you are talking on behalf of a publisher, examination board or commercial organisation, please say which:

Maximum audience size if required (if no preference please leave blank):

Audience type:

experienced trainers *

inexperienced trainers *

mixed audience *

Are you willing to repeat your presentation /workshop?

Yes *

No *

In which language do you intend to submit your presentation / workshop?*

Equipment required:
None OHP Flip Chart Multimedia Projector/Beamer Laptop
Other

If other equipment is necessary please specify:

Have you spoken at a previous ICC Annual Conference?

Yes *

No *

Have you given this presentation before?

Yes *

No *

If yes, please give details (date and location/event):

Abstract:

The abstract will appear in the conference programme and will help delegates choose the sessions they wish to attend. It will also be the basis of the conference organisers’ selection process. The abstract should therefore accurately reflect the content of your presentation. Abstracts should be no longer than 150 words.

Biodata (max 120 words):

Handouts
Speakers are expected to supply a minimum of 30 copies of each handout given in their workshops (if maximum number of participants is higher then number of copies should be higher too). There is only a limited number of copying possible at the venue.

Please also attach a Photo:

Note: Fields marked with * are required.