Phil Robinson Global Scholars' Program- 2023

Question Title

* 1. Are you an ACR/ARP Member? (Yes/No)

Question Title

* 2. ACR/ARP Member Number, if applicable.

Question Title

* 3. Last Name

Question Title

* 4. First Name

Question Title

* 5. Email Address

Question Title

* 6. Role/title

Question Title

* 7. Institution or employer

Question Title

* 8. Address (include City, Country and Post Code)

Question Title

* 9. Phone (XXX-XXX-XXX-XXXX)

Question Title

* 10. Please indicate country of citizenship:

Question Title

* 11. Please indicate country of residence:

Question Title

* 12. Do you have a Valid Passport? (Yes/No)

Question Title

* 13. Passport Expiration date.

Question Title

* 14. Current curriculum vitae (NIH format - limited to 5 pages - please include publications)

Please upload a copy of your CV

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 15. Personal statement (500 words)

Please upload a personal statement (no more than 500 words) outlining your commitment to clinical rheumatology, rheumatology education, research and advocacy and how participation in the Phil Robinson Global Scholars’ Program will advance your career or support local/regional advocacy efforts.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 16. Letter of recommendation/support

Please upload 1 letter of recommendation from a senior academician, supervisor or colleague within rheumatology.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Phil Robinson Global Scholars' Program- 2023

Question Title

* 1. Are you an ACR/ARP Member? (Yes/No)

Question Title

* 2. ACR/ARP Member Number, if applicable.

Question Title

* 3. Last Name

Question Title

* 4. First Name

Question Title

* 5. Email Address

Question Title

* 6. Role/title

Question Title

* 7. Institution or employer

Question Title

* 8. Address (include City, Country and Post Code)

Question Title

* 9. Phone (XXX-XXX-XXX-XXXX)

Question Title

* 10. Please indicate country of citizenship:

Question Title

* 11. Please indicate country of residence:

Question Title

* 12. Do you have a Valid Passport? (Yes/No)

Question Title

* 13. Passport Expiration date.

Question Title

* 14. Current curriculum vitae (NIH format - limited to 5 pages - please include publications)

Question Title

* 15. Personal statement (500 words)

Question Title

* 16. Letter of recommendation/support

* 14. Current curriculum vitae (NIH format - limited to 5 pages - please include publications)