Satellite Symposium Application Form

"*" indicates required fields

Satellite Symposia Faculty

The ANA Satellite Symposium guidelines require symposia to be well balanced. Diverse faculty representation regarding gender, race, and ethnicity is required. Please list your proposed symposium faculty below ensuring these policies are adhered to.

If you do not know your faculty or panel member(s) at this time, please list potential faculty. Faculty will need to be disclosed before your application is approved and your session date is assigned by the ANA.

Chair/Moderator #1*

Name Credentials

Title*

Institution*

Address*

City State

Email*

Chair/Moderator #2 (if applicable)

Name Credentials

Title

Institution

Address

City State

Speaker #1*

Name Credentials

Title*

Institution*

Address*

City State

Email*

Speaker #2 (if applicable)

Name Credentials

Title

Institution

Address

City State

Would you like to add more Speakers?

I would like to add more speakers.

No, I do not have any more speakers to add.

Speaker #3 (if applicable)

Name Credentials

Title

Institution

Address

City State

Speaker #4 (if applicable)

Name Credentials

Title

Institution

Address

City State

Satellite Symposium Program

Symposium Title*

Symposium Description*

Learning Objectives*

Include at least three (3) specific, measurable learning objectives that define intended outcomes for the audience.

Agenda*

Will you be offering CME/CE credit for this event?*

Yes

Please provide the name of accredited providers that will award CME/CE credit(s).*

Number of Credits*

Please enter a number from 0 to 20.

Has your organization hosted a Satellite Symposium at the ANA Annual Meeting in the last three years?*

Yes

Commercial Support

Please explain how your proposed 2026 symposium differs from the previous symposia.*

Please list any source of commercial grant support for the proposed Satellite Symposium.

List any notes or comments for the ANA Industry Innovations Workgroup to be aware of during their review process below (e.g., status of faculty invitations, etc.).

Policies, Terms & Conditions

By submitting a Satellite Symposium Application, the Certified CME/CE Provider and Commercial Supporter (if applicable) agree to the Policies, Terms & Conditions included in the ANA Exhibitor & Sponsorship Prospectus. Both parties also agree with the guidelines outlined in all supporting documentation. The submission of a Satellite Symposium Application is an offer to ANA to host a symposium during the ANA Annual Meeting. ANA reserves the right in its sole discretion to refuse to accept any Satellite Symposium Applications.

I Agree

By submitting a Satellite Symposium Application, the Certified CME/CE Provider and Commercial Supporter (if applicable) agree to the Policies, Terms & Conditions included in the ANA Exhibitor & Sponsorship Prospectus. Both parties also agree with the guidelines outlined in all supporting documentation.

The submission of a Satellite Symposium Application is an offer to ANA to host a symposium during the ANA Annual Meeting. ANA reserves the right in its sole discretion to refuse to accept any Satellite Symposium Applications.

Signature

The designated company representative (representative) listed above has full authority to submit and sign this application. The representative confirms that the company listed on this application will comply with the rules and regulations set forth in the Sponsorship, Advertising & Exhibitor Rules and Regulations in the ANA2026 Prospectus. The representative further acknowledges that the ANA reserves the right, in its absolute discretion, to reject this application.*

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