32nd Annual Scripps Cardiovascular Interventions November 16 – 19 , 2021Hilton La Jolla Torrey Pines, La Jolla, CA Faculty Presentation Release & Faculty Dinner Form Step 1 of 5 20% Please complete the fields below for your faculty participation in the Scripps 32nd Annual Cardiovascular Interventions symposium. You will receive a confirmation email after submission with a copy of your responses.Your Name(Required) First Last Your Email(Required) Enter Email Confirm Email Release FormsThe 32nd Annual Cardiovascular Interventions symposium will provide an online syllabus for attendees. The online syllabus will include all relevant meeting materials as well as the faculty slides in PDF format, when approved by the speaker. Attendees will be able to access the information for approximately one year after the symposium concludes.Permission for your presentation slides to be shared with attendees in the online syllabus as a PDF(Required) YES, I give my permission to share my slides as a PDF online with meeting attendees NO, I do not give my permission to share my slides as a PDF online with meeting attendees CRF Presentation Release FormAs part of the continuing effort by Cardiovascular Research Foundation (“CRF”) to educate and inform the medical community and the public at-large, we request your permission to post your presentation which is scheduled to be presented at the 32nd Annual Cardiovascular Interventions program on our Web site located at http://www.tctmd.com as well as any other web sites owned by CRF.Therefore, I hereby authorize and grant permission to CRF, its successors and assigns, to use my presentation materials for such purposes as they may choose. I understand, acknowledge and agree that CRF (i) may publish all or part of the presentations and any related handout materials in various print, electronic and internet-based media; (ii) may edit such recording for stylistic, grammatical or other purposes without affording me the opportunity to review or approve the final version; and (iii) may, in CRF’s sole discretion, decide not to use any or all of my presentation.I further authorize and grant permission to CRF to use my name, likeness, photograph and biographical data in connection with the use and/or promotion of transcripts or other materials published by CRF that include all or part of my presentation(s). It is also understood, acknowledged and agreed that I have not received and will not now or in the future receive a royalty or other monetary compensation from CRF for the rights I have granted in this Release. It is further understood, acknowledged and agreed that by signing this Release I am not prohibited from using my material in the future in either my personal or professional endeavors.Choose a formatting option:(Required) PDF - may be downloaded as an Adobe Acrobat file, but not altered PPT - may be downloaded as a PowerPoint file Permission is not granted Name - Signature(Required)Please enter your name again to provide your electronic signature. First Last Date of Signature(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Faculty DinnerOn behalf of the program directors, we are pleased to invite you to attend the 32nd Annual Cardiovascular Interventions faculty dinner! Thursday, November 18, 2021 Manhattan of La Jolla (Inside the Empress Hotel) 7766 Fay Ave La Jolla, CA 92037 Transportation will be provided via shuttle if desired. Please indicate if you will need transportation below. 6:15 PM - Meet in the lobby of the Hilton La Jolla Torrey Pines for the shuttle (if transportation is needed) 6:30/7:00 PM – arrival for cocktails at Manhattan of La Jolla followed by dinnerFaculty Dinner RSVP(Required) Yes, I will attend the faculty dinner myself Yes, I will attend the faculty dinner with a guest I am unable to attend the faculty dinner Transportation(Required) Yes, I/we will need transportation to the faculty dinner No, I/we will arrive at the restaurant on our own Promedica International is required to keep speaker CVs in an accreditation file. Please upload your current CV in Word or PDF format.Upload Your Current CVAccepted file types: pdf, doc, docx, Max. file size: 100 MB.Thank you for completing your faculty paperwork for the 32nd Annual Cardiovascular Interventions symposium! You will receive a copy of this form for your records via email within 3 business days. Please click "Submit" below to finalize. CURRENT AGENDA
