Satellite Symposium Application

Incomplete applications will not be reviewed for consideration.

Section I – Contact Information

Company name:

Contact (first and last name):

Program manager (first and last name):

Email address:

Telephone Number:

Section II - Commercial Support

Please list the confirmed commercial supporters for this activity. Enter N/A if not applicable.

Please attached support emails/letters from all confirmed commercial supporters.

Section III - Program Information

Proposed program title:

Therapeutic focus:

Proposed program description:

Proposed learning objectives or educational goal(s):

Proposed program length/requested AAPA Category 1 CME Credit:

1 hour	1.25 hours
1.5 hours 1.5 hours

Faculty selection criteria:

Proposed faculty:
At least one faculty member must be a PA. Please include the following: name and credentials, position title, institution, and location.

Faculty disclosure information:
All planners, faculty, and others in control of educational content must identify all financial relationships with ineligible companies within the prior 24 months. Identification standards are located here. Whether a company is eligible or ineligible is defined here.

Mitigation management plan:

Please attach the following supporting documents:
1. Needs assessment - PA performance gap analysis must be articulated.
2. Content Validation Methodology
3. Proposed Agenda
4. Outcomes Measurement and Assessment Plan
5. Sample marketing materials/examples of previous work on PA programs
6. Any other supporting documentation

Satellite Symposium Deadlines

January 31, 2024: Satellite Symposia applications due.

February 15, 2024: Tentative AAPA approval of content; AAPA agreement sent to approved programs.

March 1, 2024: Application for AAPA Category 1 CME Accreditation due for approved activities.

March 15, 2024: Signed AAPA agreement with fee due to AAPA. Electronic copies of all first draft slides, handout materials, and online CME evaluation questions submitted for initial review.

April 1, 2024: Final information for online conference scheduler due (includes program title, funder acknowledgement, learning objectives or educational goal, abstract, and program faculty, credentials, and full disclosure information). Final marketing materials, syllabus content (electronic or print), signage (electronic copies), slides, handout materials, and online CME evaluation questions due for final review and approval.

Satellite Symposium Choice

Live Only ($75,000)

Both Live and Enduring ($100,000)

Section IV - Supporting Documentation

I have read and understand the deadlines for submission of Satellite Symposium materials and information, and agree to adhere to the outlined dates. I understand that an incomplete application or submission excludes my activity from consideration for Satellite Symposium.

Yes

I have further questions, please email me.