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ESMINT Live Event Endorsement

Kindly complete the following form and attach the required document(s).

Endorsement requested(Required)

ESMINT Endorsement

WIN Endorsement

Title of the Event(Required)

Event Type(Required)

Congress/Conference/Seminar

Recorded Cases

Live Cases

Event Description (including content of activity, topics and target audience)

Start Date of the Event(Required)

End Date of the Event(Required)

Event Location

City Country

Registration or Event’s web link(Required)

Commercial Support and Industry Sponsors:(Required)

Scientific programme (including Organisational Committee and Faculty)(Required)

Max. file size: 100 MB.

Promotional Event Banner or Logo for ESMINT Website(Required)

Max. file size: 100 MB.

Preferred format: 1080 x 720 px, JPG

Name(Required)

Title First name Last name

Current affiliation

Institution Position City Country

Email Address(Required)

Email Address Confirm Email Address

Name(Required)

Title First name Last name

Email Address(Required)

Email Address Confirm Email Address

Your phone number