Abstract submission

Items with * (asterisk) must be filled in to proceed your submission.
1. Author (s)
Only the presenting author will receive correspondence and further information regarding abstract notification, grants and sponsorship.
Presenter First name Middle name Last name Country, Affiliation Email APSR Membership
1st Author*
2nd Author
3rd Author
4th Author
5th Author
6th Author
7th Author
8th Author
9th Author
10th Author
If there are more than 10 authors, please contact the Secretariat apsr2019@gakkai-web.net
2. Declarations of Interest
I declare that this work is mine and is original, unpublished and is not an encore presentation.*

I declare that none of the Authors have any links (paid or unpaid) with any tobacco or tobacco product industry.*

I hereby declare any financial or non-financial, direct or indirect relationships for the last 5 years of any of the Authors with any Commercial Entity/Industry which has products/services that are related to the Abstract.*

(Please specify sponsoring entity )
3. Abstract Content
Abstract title*
Maximum 25 characters (excluding spaces), UPPERCASE
Abstract body*

Maximum 300 characters (excluding spaces)
Click here for instructions for text which needs to be bold, italic, superscript, subscript and Special Characters.

Abstract Category*

Presentation Type*        
4. Awards Application
Select whether you wish to be considered for an award. Awardee MUST attend the Congress.*    
Abstract type*
Country of usual residence*
Society-name you belong to

    (please specify )
Birthday / /
I apply for an*
I declare that I am not in receipt of another award/travel support from another society, sponsor or employer, and undertake to declare this if such support is received after abstract submission.*