Presenter Disclosure Form
I. Please Fill out Sections I and II of the form below, you cannot speak at this educational activity, or participate in its planning or implementation. 

Please provide the requested identification information and check the participant agreement
boxes to acknowledge that you have read this for and agree to all its provisions.
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Email *
Name *
First Name
Lastname *
Surname
Institution *
Affiliation to
Do you want to Participate in SBMT2025? 
 *
I want to be in the list of presenters for 2025: Presenters SBMT 2025 (fill out form)
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