41 st Annual Scientific Meeting 24-26 October 2019 March 2019 Dear - PDF document

Association of Neurophysiological Technologists of Australia Inc ABN: 80 872 615 302 www.anta.asn.au 41 st Annual Scientific Meeting 24-26 October 2019 March 2019 Dear Member, As preparation for the 41 st Annual ANTA Conference in Perth is well underway, we are putting forward a call to our members for presentations. The conference will be held at The Duxton Hotel from 24 th to 26 th October 2019. The annual ANTA conference provides an opportunity for members to further their personal knowledge by sharing techniques, case studies and interesting syndromes with fellow members. We would love participation from Technologists/Scientists working in the field. If you are interested in contributing, please fill out the following form indicating the presentation type including equipment required so we can ensure the venue has these available for your convenience. We also require an abstract of what your oral presentation or workshop will be named so we can structure the scientific program accordingly. We would also request a brief biography to introduce you with. Both the abstract and biography will be placed in the program given to members. We require these details by Friday 9 th August via email to linda.palumbo@health.wa.gov.au or via post to: Linda Palumbo / Jennifer Stowell Neurology Department, Level 1, Clinic G Perth Children’s Hospital Locked Bag 2010 NEDLANDS WA 6909 We look forward to your participation in making the 2019 conference a great success. Regards Conference Committee 2019 ANTA Presentation Invite Perth 2019

Delegate Name _________________________________________ Presentation/Workshop Name _____________________________ Consent Photographs of presenters, members and posters are taken throughout the scientific meeting. Please provide consent for this by circling relevant response. Yes - I consent for photographs/video of me to be taken No - I do not consent for photographs/video to be taken of me Signed: ___________________________________ Date: _____________ Delegates may have videos, photos or identifying information of patients in their presentations. Please ensure consent is gained from the patient/guardian. Venue Requirements Please circle the presentation type you wish to present and circle any items you may require. Note: Depending on the Thumb tacks board available to mount Poster posters, we may not be Velcro Dots able to use Velcro. Computer/Projector Laser Pointer Presentation Whiteboard/Markers Other – please specify Whiteboard/Markers Butchers Paper/Markers Workshop Computer/Projector Laser Pointer Time Required Please circle the time allocation you would prefer: Presentation: Workshop: 30 minutes 45 minutes 30 minutes 60 minutes 2019 ANTA Presentation Invite Perth 2019

Abstract Please insert an abstract for your presentation for us to structure the scientific meeting and to place in the program for members. Biography Please include a brief biography of where you work, how long you have been in the field, interests in the field and anything else you wish to share with members, relevant to the field. 2019 ANTA Presentation Invite Perth 2019