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NASBS

NASBS

North American Skull Base Society

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NASBS Competition Time

All participating teams are required to have 5 team members and 1 team lead.

Deadline to submit team form is Wednesday, November 20, 2019.

  • Team Leader Info

  • All information regarding The Match will be sent to this e-mail
  • If any disclosures, please indicate by selecting "yes"
  • Please include the name of the company, what was received (salary, royalty, industry supported research, intellectual property rights, consulting fee, honoraria, ownership interest or other), and your role (employment, management position, independent contractor, consultant, speaking/teaching, advisory committee, review panel, board member, other).
    Name of CompanyWhat Was ReceivedRole 
  • Team Member 1

  • If any disclosures, please indicate by selecting "yes"
  • Please include the name of the company, what was received (salary, royalty, industry supported research, intellectual property rights, consulting fee, honoraria, ownership interest or other), and your role (employment, management position, independent contractor, consultant, speaking/teaching, advisory committee, review panel, board member, other).
    Name of CompanyWhat Was ReceivedRole 
  • Team Member 2

  • If any disclosures, please indicate by selecting "yes"
  • Please include the name of the company, what was received (salary, royalty, industry supported research, intellectual property rights, consulting fee, honoraria, ownership interest or other), and your role (employment, management position, independent contractor, consultant, speaking/teaching, advisory committee, review panel, board member, other).
    Name of CompanyWhat Was ReceivedRole 
  • Team Member 3

  • If any disclosures, please indicate by selecting "yes"
  • Please include the name of the company, what was received (salary, royalty, industry supported research, intellectual property rights, consulting fee, honoraria, ownership interest or other), and your role (employment, management position, independent contractor, consultant, speaking/teaching, advisory committee, review panel, board member, other).
    Name of CompanyWhat Was ReceivedRole 
  • Team Member 4

  • If any disclosures, please indicate by selecting "yes"
  • Please include the name of the company, what was received (salary, royalty, industry supported research, intellectual property rights, consulting fee, honoraria, ownership interest or other), and your role (employment, management position, independent contractor, consultant, speaking/teaching, advisory committee, review panel, board member, other).
    Name of CompanyWhat Was ReceivedRole 
  • Team Member 5

  • If any disclosures, please indicate by selecting "yes"
  • Please include the name of the company, what was received (salary, royalty, industry supported research, intellectual property rights, consulting fee, honoraria, ownership interest or other), and your role (employment, management position, independent contractor, consultant, speaking/teaching, advisory committee, review panel, board member, other).
    Name of CompanyWhat Was ReceivedRole 
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