Skip to content
Accessibility tools
LinkedIn
Facebook
Instagram
X Twitter
YouTube
Contrast
A
a
Font Size
Search
Member Center
Login
Contact
Join
Search
Menu
Home
About
About ANA
ANA Leadership
President’s Message
Diversity, Equity, and Inclusion (DEI)
ANA Staff
Partners in Academic Neurology
Memory Bank
Membership
Join
Renew
Member Categories
Member Benefits
Referral and Incentive Programs
Recruitment Toolkit
Member Directory
Education
Overview
ANA Highlights
ANA Investigates
ANA Spotlights
ANA on DEC — CME
InterACTN CME
ANA Webinars
Sponsorship Opportunities
Industry Pavilion
Committees
Publications
Annals of Neurology
Annals of Clinical and Translational Neurology
Annals of the Child Neurology Society
Awards
Meetings
Annual Meeting
Future Annual Meeting Dates
Research Careers Reimagined Course
Annual Meeting Final Programs
Careers
Careers Center
ANA Placement Service
News
Chair/Co-Chair/Vice Chair Information Form
Chair/Co-Chair/Vice Chair Information Form
"
*
" indicates required fields
Name
*
First
Last
Credentials
*
Please use all uppercase letters (MD, PhD). Please refrain from using periods (M.D., P.h.D.) Be sure to enter your credentials exactly as they should appear in meeting related materials or messaging.
Institution
*
Please provide us with the institution that you are currently at, not where you received your education. Please refrain from using acronyms (UCLA, GSU, FSU). Be sure to enter your institution name exactly as it should appear in any meeting related materials or messaging.
Primary Title
*
Primary Department
*
Primary Affiliation
*
Email
*
Assistant's Name
First
Last
Assistant's Phone Number
Assistant's Email
Session Type
*
Make a Selection
Plenary
Special Interest Group
Interactive Lunch Workshop
Professional Development Workshop
Session Title
*
Biography Narrative
*
100 words or less
Accepted file types: txt, doc, docx, pdf, Max. file size: 2 MB.
Professional Headshot
*
Accepted file types: jpg, jpeg, png, Max. file size: 10 MB.
Δ
