Shingo Fujii Young Doctor Summit Registration

October 28, 2016
11:00 a.m. - 6:00 p.m.
Lisboa Conference Center

The IGCS is hosting the Shingo Fujii Young Doctors Summit one day prior to the 2016 Biennial Meeting for multidisciplinary early career professionals involved in the prevention, research, treatment or care of gynecologic cancers. IGCS is offering up to twenty travel grants for members from low and mid income economies to attend the Summit and the Biennial meeting.

Registration to this summit is free, but individuals who are not eligible for or not selected for a travel grant must register for the Biennial meeting and pay the registration fee at www.igcs2016.com.

Space is limited to 100 seats.

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* 1. Name:

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* 2. Email address:

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* 3. Institution:

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* 4. Mailing Address:

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* 5. Country of Residence:

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* 6. Please select the statements that apply to you.

I am currently in training in gynecologic oncology, surgical oncology, radiation oncology, medical oncology or pathology.

It has been less than five years since my fellowship/apprenticeship.

It has been less than five years since I completed residency.

It has been less than ten years since I completed medical school.

Please list your graduation dates for Medical School, Residency and/or Fellowship if applicable.

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* 7. Are you applying for a travel grant?

Please note that only IGCS Members from low and middle income economies are eligible for a travel grant. Twenty Members will be selected.

Yes

No, I am not eligible for the grant.

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* 1. Name:

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* 2. Email address:

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* 3. Institution:

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* 4. Mailing Address:

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* 5. Country of Residence:

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* 6. Please select the statements that apply to you.

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* 7. Are you applying for a travel grant? Please note that only IGCS Members from low and middle income economies are eligible for a travel grant. Twenty Members will be selected.

* 7. Are you applying for a travel grant?

Please note that only IGCS Members from low and middle income economies are eligible for a travel grant. Twenty Members will be selected.