Local Organizing Committee Interest Form

ISCD offers Local Organizing Committees the opportunity to license and offer specific ISCD educational programs. This form is only a request for further information. Additional information, application, and license agreement will be provided to the requesting party upon submission and review of this interest form.

The finalized LOC agreement shall be confined to a single offering of the specified ISCD educational program and shall be extended solely with the intent to license ISCD educational resources to the LOC for the duration of that offering. ISCD charges an administrative fee per educational course offering, due at the time of application. All expenses incurred in the presentation or offering of the course are the responsibility of the LOC.

Sponsoring Organization (LOC)*
Name of the organization that will be sponsoring the course.
Course Requesting*
- DXA Body Composition Analysis (admin fee $500)
- Pediatric Bone Densitometry (admin fee $500)
- Vertebral Fracture Assessment (admin fee $500)
Please choose the course you are requesting to host.
Course Start Date*
Date you plan to offer the course (mm/dd/yyyy).
Administrative Contact Name*
First Last

Enter the full name of the Administrative Contact for the course(s). This is the person who will receive all communication, and the course material, from ISCD.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Enter LOC Administrative Contact Mailing Address.
Phone
Enter LOC Adminstrative Contact telephone number.
Email*
Enter Email Confirm Email

Enter LOC Administrative Contact email address. All correspondence will be sent to this address.
Name
This field is for validation purposes and should be left unchanged.

Last modified: January 6, 2013

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