Sponsor a Colleague: International Palliative Care Network Conference 2017 - Sponsor Application
The Sponsor a Colleague program was developed to provide access to palliative care education from professionals worldwide to international practitioners that are unable to cover the registration fee. The sponsorship will provide registration for the International Palliative Care Network Conference 2017. Sponsorships will be awarded based on the number of sponsored registrations. Priority will be given to those with greatest potential benefit and those working at academic or teaching facilities.

Sponsorship recipients will be expected to submit a poster about his or her program and the work being done and submit four quarterly reports with updates on how the conference has impacted his or her daily work.

First Name *
Surname/Last Name *
Professional Credentials *
Professional Title *
Facility, Institution or Organization Name *
Location (City, State/Province, Country) *
Email address (all applicants will be subscribed to PCN newsletter) *
In promoting the Sponsor a Colleague program PCN will be using the PCN-e.com website and various social media platforms. If you would like to have your name withheld please request your profile be anonymous.
Do you wish for your gift to remain anonymous? *
What is your Twitter handle? (eg - @PCNVoice)
What is the link to your Facebook page? (eg - https://www.facebook.com/your_name
What is the link to your LinkedIn profile? (eg - https://www.linkedin.com/in/your_name)
How many colleagues would you like to sponsor? (Registration fee is $150 per person - a savings of $25 off normal registration fee) *
To process your sponsorship follow the link to donate: http://www.pcn-e.com/donate/.
Please type your full name to acknowledge understanding of the sponsorship program. *
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