Application for Endorsement without CME

Program planners are urged to complete the CME application at least six months prior to printing brochures or other course documents. A preliminary program brochure containing a complete agenda with invited faculty must be submitted with your application. Please return the application with the requested documentation attached, along with the application fee to ASE. Applications will not be reviewed unless all requested documentation is included. Payment must be received prior to review. You will receive written confirmation that your application has been received at ASE. Applications are reviewed by the CME staff for completeness. Incomplete applications will be returned to you with a checklist requesting the missing information. Complete applications are circulated to the Review Committee for determination of endorsement. The Committee requires at least 10 business days for review of an application. You will be notified, in writing, of the Committee's decision. ASE reserves the right to deny endorsement of any activity without cause. No materials may be printed using the ASE name and/or logo until the program has been approved and the materials have been individually reviewed and approved. All promotional materials for ASE endorsed educational activities must be approved by ASE staff in writing prior to printing and distribution.

•    The completed ASE endorsement application, including attachments, should be submitted to the ASE CME Office at least six months prior to distribution of promotional materials.

•    At least 10 business days are required for review of a submitted application. This estimate of time may change due to application volume. ASE reserves the right to deny any application for endorsement without cause.

•    Under no circumstances may the ASE name and/or logo be used to promote an educational activity prior to receipt of written approval of ASE endorsement.

•    Upon receipt of written approval of ASE endorsement, a signed letter of agreement should be returned to the ASE CME Office no later than 15 business days after receipt

•    All printed materials must be reviewed and approved by the ASE CME Office prior to printing and distribution.

•    At least 30 days prior to the start of the activity, the course planner should provide ASE with a mailing address for shipment of ASE's educational materials, which will be made available to attendees onsite at the program.

• Events put on by industry vendors and CME provider companies are not eligible.

The American Society of Echocardiography (ASE) is a global, multicultural, and inclusive organization. Our membership is open to all those invested in cardiovascular ultrasound. We value the variety of approaches and perspectives in healthcare. We recognize that diversity in all aspects (e.g. age, race, ethnicity, gender identity, sexual orientation, religion, and disability) drives innovation and contributes to building a holistic culture that will, in turn, enhance our ability to care for our patients and eventually benefit those living with cardiovascular disease. Including diverse individuals adds value to our activities by increasing the range of experience, ideas and perspectives. We will strive to build a diverse and inclusive organization at all levels, including leadership, staff, councils, committees, task forces, faculty, writing groups and other volunteer activities. This pattern of diversity and inclusion will be reflected in all our activities internally and with our vendors and partners.

A letter of approval from the primary sponsor and any other sponsoring institutions is required and must accompany this application

Dates must be fully outside of ASE's black-out policy. Contact ASE staff if you have any questions regarding blackout dates or policy as found on the website.

ASE Members are to pay no more than 80% of the non-member fees. ASE Physician/Scientist Member: $740 Non-Member Physician/Scientist: $930 ASE Non-Physician Member (Cardiovascular Sonographer/Nurse/Student): $595 Non-Member Non-Physician (Cardiovascular Sonographer/Nurse/Student): $745

CME activities should be developed in the context of desirable physician attributes. Please indicate which of the ACGME/ABMS or IOM core competencies will be addressed in this activity.

A CV and current disclosure information for all program chairs and/or co-chairs MUST be included with the application. ASE requires that at least the Program Chair must be a current member of the Society.

It is required that you submit a copy of all brochures, flyers, syllabi and other written material for this program to the ASE CME Office prior to printing for our review and approval. The ASE logo must appear on the front and back of all materials with the following statement "Endorsed by the American Society of Echocardiography."

**Must adhere to ACCME Guidelines on advertising

ASE requires that final drafts of the following items be kept on file in our office for all ASE endorsed educational activities: •    Two (2) copies of all promotional materials, including save-the-date cards, registration brochures, etc. •    Two (2) copies of all handouts and/or syllabus materials provided to attendees onsite. •    One (1) electronic copy of the final faculty and attendee list, including name, address, phone, and email contact information. •    One ( 1) electronic copy of the final summary of the attendee program and faculty evaluation. Copies of the above items should be on file in the ASE office within two months of the completion of the educational activity.

The following items are REQUIRED application materials. Please use the File Upload Box below to submit the following items: 1. A Preliminary program brochure containing a complete, hour-by-hour agenda with invited faculty for each date of the program. 2. A copy of the Attendee Program & Faculty Evaluation attendees will use to evaluate the effectiveness of the educational content and the faculty presenters. 3. Previous Year's Evaluation Summary (for annual events) 4. Chair/Co-Chair CV's & Disclosure Information

I hereby certify that the above statements are correct and complete. As Course Director, I certify that a proposed budget for this meeting has been submitted to and reviewed by the sponsoring organization, and agree to display and make available onsite to attendees ASE educational materials, which ASE will provide. If the educational program includes industry exhibits, I agree to offer ASE complimentary space if requested. I understand that I am required to send ASE the final faculty and attendee list including name, address, phone and email, within 2 months of the completion of the education activity. I understand that ASE does not certify that attendance at an ASE endorsed course guarantees competence or proficiency in the performance and/or interpretation of cardiovascular ultrasound. I understand and agree that if this course is approved for ASE endorsement, ASE assumes no financial obligation to this course; all expenses incurred by this activity are the responsibility of myself and/or the sponsoring organization. I understand that the endorsement application fee is non-refundable and submission of this application does not imply course endorsement by ASE; the endorsement decision is at the sole discretion of the American Society of Echocardiography.