AACE Satellite Symposium Request Form
Requests are made by medical education/management companies that wish to hold industry supported satellite symposia
at the AACE Annual Meeting. One form should be submitted per activity and commercial entity that the activity is
being submitted to for support. Please remember that request form must be submitted before any grant requests
are sent to potential commercial supporters, including responses to RFPs- grant requests may only be initiated once
authorization is provided by AACE.
Title of Proposed Activity:
Live +Enduring- please indicate which type(s) of enduring activities are being proposed (check all that apply):
On-line Activity CD-ROM/Tape Program Stand-Alone Publication
Endocrine Practice Journal Supplement Two Media with exact same content e.g. Online & Monograph)
Other, please describe (will require AACE approval and advice on fees):
Please indicate if live and enduring activities are to be submitted on-
Same Grant Request Separate Grant Requests
Commercial entity that this activity will be submitted to for support:
Is this in response to an RFP? Yes- RFP #
Grant requests may not be submitted until AACE authorization is provided.
Please see AACE Satellite Symposia Guidelines for additional information regarding this process.
I have read the AACE Satellite Symposia Guidelines and agree to comply with all AACE policies and procedures
including, but not limited to-
AACE is the sole accredited provider and grant payee for satellite symposia- both the live activity and any
enduring spin-off materials. Applications with alternate provider/payee information cannot be accepted.
Activity budget(s) must include the appropriate allotments for AACE live and enduring fees, along with other
required expenses (i.e. brochure mailing, speaker expenses, etc.)
Printed Name: Date:
Please send completed and signed forms to:
Attn: LouAnn Griebel
Email: email@example.com; Fax: 904.535.7878
245 Riverside Ave, Suite 200; Jacksonville, FL 32224