Regional NET Conference Application Many neuroendocrine (NET) patients travel hundreds of miles to seek expert advice regarding their disease, only to find that their care is fragmented when they return home. Other patients do not have the resources (financial or otherwise) to seek out a recognized NET expert for consultation. Additionally, some patients embark on a treatment strategy that appears to adversely affect quality of life and/or outcomes. As a professional organization, NANETS is committed to provide educational training to further advance its mission, increase patient access to clinical trials and improve the ability of NET patients to receive a comprehensive, multidisciplinary management plan. If you are interested in working with NANETS to conduct a CME-certified regional NET conference to educate health care providers in your community in the recent advances in the field, please complete this application and the Regional Conference Agreement and return it to Kari Brendtro @ kari@nanets.net. * Sample Agenda for guidance regarding suggested content & speakers is attached. Your Name ___________________________________ Specialty ___________________________________________ Sponsoring Dept._________________________Host Organization/Institution___________________________________ Proposed Month(s) for Conference: ______________________ Radius for Attendance:______________________ How many NET patients annually are seen in the department/institution? __________________ How many speakers and from what institutions within the region are you including in the program? 1. 2. 3. 4. Name Name Name Name & & & & Institution Institution Institution Institution Is the Host Organization and Speakers willing to follow the timeline below? Yes_____ No_____ How many guest speakers and from what specialty from NANETS do you want to invite? __________________________ ________________________________________________________________________________________________ What is your goal in having this meeting? _______________________________________________________________ ________________________________________________________________________________________________ Do you want to use your institution’s CME Provider? Yes __________ No __________ The goal for attendance at this event is 60 - 100 attendees. Is this a realistic number for your area? Yes____ No_____ (these numbers include speakers, exhibitors, students, residents, fellows, nurses, pharmacists, and midlevel providers. Registration fees are as follows: MD $50; RN/mid-level $25; residents/fellows/students – free) Is the Host Organization/Sponsoring Department willing to follow the suggested timeline below? Yes____ No_____ Other Comments___________________________________________________________________________________ ________________________________________________________________________________________________ Timeline for Host Organization/Speakers: 3-6 months in advance: Identify date & in conjunction with NANETS for conference venue for conference Finalize agenda/speakers (both local/regional/experts) with NANETS representative Provide NANETS with faculty contact information 3-6 months in advance: Save the date postcards emailed (NANETS will provide) Send personal emails/calls to referral providers Invite potential exhibitors and send NANETS all contact information 2-3 months in advance: Supply an excel spreadsheet of addresses for bulk brochure mailing to NANETS Provide NANETS with number of brochures needed for personal mailings Assess registration information to date 6-8 weeks in advance: Mail brochures with personal letter to colleagues/referring physicians Advertise through CME website, newsletters, social media, Cancer Center/Med Center website, liaison for referring providers 4 - 6 weeks in advance: Check with NANETS representative to assure faculty has provided presentation outline Continue to advertise through CME website, newsletters, social media, Cancer Center/Med Center website, liaison for referring providers Send reminder to all faculty to invite colleagues & referring providers to the meeting 2 weeks in advance: Check with NANETS representative to assure faculty has provided PPT to appropriate individuals Continue to advertise through CME website, newsletters, social media, Cancer Center/Med Center website, liaison for referring providers Registration Check-In with NANETS should be done at 6 weeks, 4 weeks, 3 weeks, 2 weeks & 1 week prior to event. Timeline for NANETS: 3-6 months in advance: Choose venue in conjunction with Host Organization for conference Contract with venue Finalize agenda/learning objectives with Host Organization representative Identify speakers (both local/regional/experts) with Host Organization representative Identify CME provider and complete CME application for accreditation Develop conference budget Send invitations to faulty 3 - 6 months in advance: Supply PDF of the Save the date postcards to Host Organization for distribution Draft brochure Send sponsorship opportunities to potential exhibitors/supporters Book hotel and travel for out of town speakers 2- 3 months in advance: Develop brochure & send PDF to Host Organization Assess registration information to date Send personal letter templates to institution/faculty 6-8 weeks in advance: Mail brochures via mail lists and to Host Organization as requested Send faculty sample outlines & PPT’s for review 4 - 6 weeks in advance: Send reminder to faculty to provide presentation outline to NANETS Send reminder to all faculty to invite colleagues & referring providers to the meeting Collate & print conference syllabi Assure faculty has provided PPT to appropriate individuals – review content 2 weeks in advance: Assure faculty has provided PPT to appropriate individuals – if requqired Supply conference venue with meal choices, AV & room set up requirements Send faculty memo with conference details (time to arrive, parking, etc) Continue to advertise through CME website, newsletters, social media, Cancer Center/Med Center website, liaison for referring providers