Almirall Dermatology Award

Registration

The next submission of the Almirall Dermatology Award will be made during the 47th Congress of the German Dermatological Society (DDG) in 2013 in Dresden.

Date for submissions

One copy of each paper is to be submitted together with the application form and a academic CV until the 15th of February 2013.

Almirall Dermatology Award
Scientific Committee
Scholtzstraße 3
21465 Reinbek

Personal details:

Please complete all mandatory fields marked with *.

Form of adress*

Title

First name*

Surname*

Birthdate

Clinic / Institute*

Position*

Adress*

Telephone*

Fax

E-mail*

Brief information about the paper submitted:

Please complete all mandatory fields marked with *.

Topic*

Authors*

(Please indicate all authors who collaborated on the creation of the paper)

Objective*

Abstract*

Result*

The submitted paper is on*:

Diagnostics

Therapy

Method development

The following indication

All the co-authors have given their consent allowing me to apply for the Almirall Dermatology Award with this paper. A written declaration of this consent from all co-authors is enclosed with this application*.

Yes

I have submitted this paper for other awards*

Yes

The paper / parts of the paper have already been published (no longer than 8 months ago)*

Yes, citation