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SUNA Advanced uroLogic Registration Scholarship - Arthur T. Evans Memorial Scholarship

SUNA Member for 2 or more years

Dr. Arthur T. Evans was one of the founding fathers of the AUAA. In the late 1960s, the AUA recognized the need for specialty education of supporting personnel - the urology nurse, technician, and physician's assistant. Dr. Evans was one of the leaders who was instrumental in influencing the AUA to create an Allied division as part of its organization. In 1969, the Allied Health Professions Committee of the AUA was formed, with Dr. Evans as chairman. This scholarship, established to recognize Dr. Evans' many contributions to allied urologic education, will be awarded to an allied health professional in the field of urology who is a SUNA member. Preferences will be given to someone who is certified by CBUNA.
1.Name, include credentials
2.Street Address, City, State, Zip
3.Phone (best way to reach you)
4.Email Address:
5.Active member of SUNA for the past 12-23 months?
6.SUNA Member since?
7.SUNA Activities (National, Regional and Chapter)
8.CBUNA Certified?
9.CBUNA Credential
10.Education (Place, Graduation Year, Degrees, Certifications)
11.Employment for the past 5 years (Name and position)
12.Articles and/or Presentations in the past 5 years:
13.Type of urologic care you provide:
14.Describe your work setting, your role at work and how this conference will benefit 1) you and your personal growth, 2) benefits your practice, and 3) how information will be disseminated to other heal care team members. Please be specific but limit your comments to 350 words.
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