International Association of Gerontology and Geriatrics (IAGG) Master Class on Ageing

Theme: Intensive Training on Ageing and Geriatric Medicine

29 – 31 August 2012Hong Kong SAR, China

Co-organized by:

International Association of Gerontology and Geriatrics

(IAGG)

The University of Hong KongLi Ka Shing Faculty of MedicineResearch Centre of Heart, Brain,

Hormone & Healthy Aging

The Hong Kong Geriatrics Society

COURSE APPLICATION FORM

Please read the following notes before competing this form:1. Basic admission requirements include: Medical Practitioner with Bachelor Degree in Medicine2. Applicants are advised to provide all the information requested in the form, where applicable,

failing reaching the Course Provider may not be able to process and consider your application.3. Please send the completed form together with the updated Curriculum vitae ( CV ) by e-mail to

hbha@hku.hk to the Course Secretariat, Research Centre of Heart, Brain, Hormone & Healthy Aging on or before 7 July 2012

4. Please submit an abstract for poster presentation.5. FREE registration and an official acceptance letter of admission will be provided to every

successful applicant.

1. PERSONAL INFORMATION:

Surname: Given name (in full):

Nationality:

Correspondence

Address:

Contact phone no: Email address:

2. YOUR CURRENT POSITION:

Institute:

Department:

Country:

Current Position & Specialty:

Start Date:

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3. ACADEMIC QUALIFICATIONS: (most recent first)

i. Title of Degree: Year Obtained:

Major Subject:

Institution:

Country:

ii. Title of Degree: Year Obtained:

Major Subject:

Institution:

Country:

4. DETAILS OF YOUR CURRENT SUPERVISOR

Surname: Given name (in full):Department & Institution:

Position:

Correspondence Address:

Contact telephone no: Email address:

5. SUBMISSION OF ABSTRACT FOR POSTER PRESENTATIONS

Instructions and Format for Abstracts:

(a) All applicants for the (IAGG) Master Class on Ageing are required to submit an abstract for poster presentation in MS Word format with the abstract form below to the Course Secretariat by 7 July 2012 via email at hbha@hku.hk

(b) All abstracts must be written in English within an A4 page and set in Times New Roman with no less than 10 points in font size.

(c) The title of the abstract should be typed in Capital Letters. Authorship: initials followed by family name, and underline the presenting author (please also list the address(es) / institution(s) of the authors).

(d) The objectives, methods, results and conclusions should be described. One figure or table may be included, though at the expense of the total number of words.

(e) Confirmation of acceptance of abstracts will be communicated to the Presenting Author by 20 July 2012 . The exact schedule of presentations at the Course will be communicated to the Presenting Author by 17 August 2012 .

(f) In addition, applicants are required to prepare their abstract for poster display and presentation at the designated sessions during the course once their abstracts are accepted. All posters must be affixed on the assigned display unit measuring 990mm (H) x 690mm (W) before 13:00 on 29 August 2012 and removed by 31 August 2012.

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Topics: Title:1. Biology of ageing

and longevity2. Demography and

epidemiology of Ageing

Authors and Institutions

3. Falls

4. Dementia and cognitive impairment

Content of the abstract

5. Stroke

6. Parkinsonism and Gait disorder

7. Metabolic, endocrine and nutritional disorders

8. Sarcopenia and Frailty

9. Continence

10. Cardiovascular disorders

11. Rehabilitation

12. Palliative and end-of-life care

13. Nursing home care

14. Community home care

15. Others

ABSTRACT FORM

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6. DECLARATION AND SIGNATURE

I declare that the information I have given in this application is correct and complete to the best of my knowledge and belief. I agree that the course organizer may conduct a reference check by contacting my present supervisor(s) and or institution(s).

Signature: Date: __________________________

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