National Representative Report submission form

Period covered by this report

National Representative

Your name

Your email address

The country you represent

Your contact telephone

Your social media handle(s)

Have you read the summary of responsibilities of National Representatives?

Yes

National Society

Name of society

Current president

Current secretary

Next annual meeting dates

Annual Meeting organiser contact details

Does your national society wish to receive ESCP's e-newsletter?

Yes

If yes, please include contact details (name, email, position)

If no, why not?

Promoting ESCP and our activities

ESCP Educational Events

Have you or will you be able to promote ESCP’s masterclasses and other educational events at your national meeting this year?

Yes

If no, why not?

Does your national society website list ESCP’s masterclasses and other educational events?

Yes

If no, why not?

Social Media

Do you follow ESCP on:

X/Twitter

Facebook

Instagram

If none of these, why not?

Does your national society follow ESCP on:

X/Twitter

Facebook

Instagram

What platforms does your national society use?

Contributing to ESCP Website

National Area page

Do you check your national area page regularly and provide updates updates every 6 months?

Yes

If no, why not?

Events Listing

Have you or has your society contributed any of the following to the events listing on ESCP's website in the last quarter?

Events run by your society

Yes

If yes, how many?

If no, why not?

Events run by another organisation

Yes

If yes, how many?

If no, why not?

Research section

Have you or has your society contributed any of the following in the last quarter?

Case Reports

Yes

If yes, give the title of the case report here

If no, why not?

International Trials

Yes

If yes, give the name of the trial here

If no, why not?

Further information

Are there any future educational initiatives you and your national colleagues would like ESCP to undertake?

What do you and your national colleagues think are the main priorities/topics for discussion at the forthcoming National Representatives’ Forum at ESCP's Annual Meeting?

Annual Report

The following information is only required for the period Q3 Annual Report

How many ESCP members are there for your country at the time of this report?

How many ESCP members were there for your country one year ago?

Have you contacted ESCP Secretariat for any membership reports this year?

Yes

If no, why not?

Please give a brief report of any activity not detailed above that you have undertaken this year to engage non-members of ESCP and encourage them to join:

Please provide any further information about your national activity or achievements during the past year:

National Representative Report submission form