This may include committee membership or leadership, presentations at the annual meeting, participating in special programs or DFPs, etc.

Supply any other comments/information (health factors; special experience; personal commitments) that the Committee should take into consideration when evaluating this application

Lectures

List eight (8) lectures that you are prepared to present during this meeting.  Please list them in order of preference, with one (1) being the highest and eight (8) being the lowest.  Keep in mind that typically 2-5 lectures will be selected for presentation.  For each lecture, please note the area of practice (GI or GU) that it is most closely related to.

Please list topics of expertise and any other available lectures you'd like to share. The host society may provide the SAR with a list of requested topics, and this information may help us to match Faculty expertise with their requests. (Examples: GYN; Body MRI; Dual Energy CT; Pancreatitis; Ovarian Imaging; Prostate Cancer; LiRads; MR Enterography; CT Colonography; Tumor Ablation; etc.)

Will you allow for your presentation(s) to be recorded (for educational archive, not for distribution or broadcast)?

Supporting Materials

Any materials not submitted through this form should be sent right away to admin@abdominalradiology.org.  

Travel and Expenses

Tentative Travel Schedule: October 31- November 5, 2019 |Costa Rica

• Arrival- San Jose on Thursday, October 31
• Lecturing- Friday and Saturday, November 1 and 2
• Touring- Sunday and Monday, November 3 and 4
• Returning- Tuesday, November 5

More information will be available as the program develops.  While the additional tours and excursions are optional, submitting your application confirms that you will be able to arrive in the host country the day before and stay through the duration of the scheduled SAR lecturing days.   

The SAR will cover up to $2,000 for all travel expenses to/from the host country, including economy airfare, baggage and ground transportation. If participation in this year's program required you to personally cover additional expenses, would you still be able and interested?

Q: What is the range or estimate of supplemental funding you would be able/willing to utilize? (note: this information will remain confidential among the selection committee only).

CONFIRMATION

By entering your name below and completing this form, you confirm that you understand the eligibility requirements and guidelines of the program, plan to participate in the meeting over the dates listed, and are prepared to cover any costs not covered by the Host Society or the SAR.