2024 VAFP Application for Scholarly Symposium

Thank you for your interest in submitting scholarly activity for inclusion in the VAFP Scholarly Symposium. The event is scheduled for Saturday, November 2, 2024. The deadline for submissions is October, 11, 2024.

Please complete the application below.

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* Please Enter Your Contact Information Below

First Name

Last Name

Suffix (MD/DO) if applicable

E-mail

Cell Phone

Medical School/Residency Program

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* Type of Scholarly Activity/Project

Oral Presentation on Completed Scholarly Activity

Oral Presentation on Work in Progress

Poster on Completed Scholarly Activity

Poster on Work in Progress

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* Title of Scholarly Work

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* Abstract (250 words or less)

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* Please enter at least 2 learning objectives for your research.

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* Briefly describe how/why you became interested in pursuing your research project?

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* Lead Presenter/Lead Author

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* Lead Presenter(s) is

Medical Student

Resident

Fellow

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* Lead Presenter(s) is

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* Additional Author(s)

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* Was an Advisor or Coordinator involved?

Yes

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* If an Advisor or Coordinator was involved, please indicate their name and email address.

Name(s)

Email(s)