Poster Application Form 2025

Personal Information

(Labels in BOLD text and with a red * are required fields)

Honorific
First Name
Last name
E-mail
City
State/Province/other
Country

Mentor (name)	Mentor email

Second Presenter name (if any)
Second Presenter email (if any)

Poster/Abstract Information

Title (max. 12 words)
Topic
Presentation Type
Keywords (max. 3 keywords)
Author list
Purpose/Aim (max. 25 words)
Materials & Methods (max. 300 words)
Results (max. 50 words)
Conclusions (max. 25 words)

Affirmations:
The author(s) confirm that the submission is in compliance with the IRB and HIPAA regulations for their institution.

IRB/HIPAA Compliant?

I acknowledge that this presentation will be published in a digital format that is accessible to judges and members of this organization, and grant permission for it to be displayed for those purposes on maxillofacialprosthetics.org

Disclosure

UNBIASED PRESENTATION - A potential conflict of interest does not exist. Neither I nor any member of my family has any financial arrangement or affiliation with a corporate organization offering financial support. Nor do I have a financial interest in a commercial product or service that I will discuss in my presentation. Therefore, my presentation is unbiased in nature.

BIASED PRESENTATION – A potential conflict of interest does exist. I or a member of my family has a financial arrangement or affiliation with a corporate organization offering financial support. Or, I have a financial interest in a commercial product or service that I will discuss in my presentation. Therefore, my presentation is biased in nature.

Consider for Awards/Competition?

Note: The AAFP is only accepting abstracts at this time. Only approved abstracts will be asked to submit a poster.

Tylman Awardee?
Yes No

Affiliation (School)

Affiliation (School) - Other

If you have Instagram and would like us to tag you, please provide your Instagram handle:

If you have Facebook and would like us to tag you, please provide the complete Facebook profile URL:

Office use only: