Nomination Form

Attendees of the SMRU 2024 Fellows' Symposium are required to:

  • Hold membership in both ASRM and SMRU (associate).
  • Commit to attending all days and sessions of the symposium.
  • Fulfill all pre and post surveys and course evaluations as requested.
  • Any cancellation after airfare purchase will result in full reimbursement to ASRM.
  • Cancellation of the rafting event after confirmation will incur a full reimbursement to ASRM at $150 per person.
Questions should be emailed to Megan Miller, SMRU Administrator, at mmiller@asrm.org.

Nominations DUE NO LATER THAN MONDAY, MAY 13, 2024.

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* 1. Institution:

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* 2. Director:

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* 3. Director email:

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* 4. Program Coordinator:

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* 5. Program Coordinator Email: 

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* 6. Is the Program Director a member of ASRM/SMRU?

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* 7. Does the program participate in the AUA Andrology match?

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* 8. Current Fellow, as of August 2024, nominated to attend:

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* 9. Is the fellow an Associate Member of ASRM/SMRU?

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* 10. Do you need to enter additional fellows?

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