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First name * (Required.)

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Last name * (Required.)

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Phone number * (Required.)

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Address * (Required.)

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Are you currently in a fellowship training program? * (Required.)

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Institution name *
If you are not currently in a fellowship training program, please write "N/A" (Required.)

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What is your level of interest in lung cancer on a scale of 1–5, 1 being “Not interested at all” and 5 being “Very interested”? * (Required.)

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About what percentage of your clinical time is dedicated to lung cancer patients? * (Required.)

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Are you currently involved in thoracic oncology research (e.g., clinical trials, translational work, publications)? * (Required.)

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In what ways do you hope to influence the future of lung cancer care over the next 5-10 years? * (Required.)

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Have you published, presented at national meetings, or contributed to educational content? * (Required.)

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What do you hope to gain from participating in a program focused on clinical thought leadership and professional networking? * (Required.)

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What topic area are you most interested in learning more about? * (Required.)

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Please share your LinkedIn profile *
Please include the full address starting with https://

Before completing your application, please read and agree to the terms below:

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I agree that after I have confirmed my availability to attend the program, I will attend the program sessions in full and complete required pre- and post-meeting surveys. * (Required.)

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I understand that failure to send a cancellation request or attend the Rising Stars Fellows Program in full may result in ineligibility to attend future HMP-hosted programs. * (Required.)

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I agree to submit my travel itinerary including flight information as soon as I have confirmed my availability to attend the program or by the published deadline, September 14th. * (Required.)

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