Chief Resident Application Survey for AOAO Meeting Funding

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* 1. Please provide your contact information below, include your first and last name, mailing address, email address and phone number. This information is required to notify you of acceptance and process your reimbursement.

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* 2. Name of your residency training program.

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* 3. Name of your Program Director.

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* 4. How will you attend the Annual Spring Meeting, April 15-17, 2021 in Salt Lake City, UT?

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* 5. Do you plan to continue your training in a fellowship?

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* 6. If yes, please let us know where you will train so we may extend your free membership.

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* 7. If no, please give us your new practice information so we can make sure you receive the discounted member rate for your first year in practice.

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* 8. The Academy would like to add subject matter to future meetings of interest to our Candidate/Resident members. Please check below which topics are of interest to you.

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