2019 SPLIT Coordinators Grant Application 2019 SPLIT Coordinators Grant Application ObjectiveTo support the travel of SPLIT Coordinators to attend the Annual Meeting and be able to connect with a community of coordinator mentors.This award program includes the following components: Free SPLIT Annual Meeting registration Grant for reimbursable travel expenses up to $750 to attend SPLIT Networking opportunities at SPLIT EligibilityWe will be considering candidates who are actively involved in SPLIT through committee membership and participation, wish to gain practical knowledge at the Annual SPLIT meeting, as well as have an opportunity to connect with a community of coordinator mentors. Application RequirementsApplicants are required to submit the following: A personal statement including current and past involvement in SPLIT, including but not limited to: Committee involvement Participation in QI and/or research projects and Personal importance of attending the meeting 2. Letter of recommendation from their PI or Co-PI to address: What are the perceived goals for the Coordinator for attending the SPLIT Annual Meeting? Please comment on the Coordinator’s current efforts within SPLIT including data entry, committee involvement, QI or research involvement and any prior meeting attendance. Evaluation Criteria Applications will be scored by members of the Education Committee and Chairs of the Coordinator Committee on the following criteria: 1. Commitment to SPLIT committee involvement2. Involvement in QI and/or research projects within SPLIT or center3. Personal importance of Annual Meeting attendance4. PI or Co-PI support OK Question Title * 1. Please provide your contact information. First Name Last Name City/Town State/Province Country Email Address OK Question Title * 2. Please select the Society memberships you currently maintain? TTS SPLIT OK Question Title * 3. Please upload your personal statement and letter of recommendation. Must be submitted with application in order to be considered. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please upload your personal statement and letter of recommendation. Must be submitted with application in order to be considered. OK Applications must be received by June 14, 2019.Saeed Mohammed, MD and Dana Mannino, RN, MSNCo-Chairs, SPLIT Education Committee*Award funds are transferred following the conclusion of the meeting. OK DONE