Course Endorsement Application Review the ASMBS Course Endorsement Policy prior to completing this application. Click here to submit an application by mail. Please complete the following for your course, program or event:Title*Sponsoring organization (spell out name)*Dates*Location*Website* Expected number of attendees*Will CME credits be issued?*YesNoIf the course, program or event is not organized by a non-profit organization or group please explain how profits will be used.Attachment 1: Responsible persons list*A list of persons responsible for design, content formulation, faculty designation, and other organizational aspects of the program and contact information (including phone and email) for the primary program director. (Maximum file size: 8MB)Attachment 2: Course brochure*A course brochure with course objectives, target audience, program outline with faculty or a draft of the program agenda with the faculty names. (Maximum file size: 8MB)Course Endorsement Application Fee Price: $500.00 Contact Email* Enter Email Confirm Email Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Need help? Contact ASMBS at email@example.com, call (352) 331-4900 or contact ASMBS online.