2010 SIR Foundation Dr. Gary J. Becker Young Investigator Award

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Application Materials and Manuscripts Due: Friday, November 13, 2009 5:00PM EDT

Questions? Call (703) 691-1805

Application Instructions
Applicants are required to submit:

Manuscript (one that has been published within the last year or is being considered for publication).
CV
Colored Photo
Letter from program director or department chair attesting that the work is the primary effort of the applicant.
Document stating your contributions to the IR community as well as patient care/teaching.

Applicant Contact Information

First Name *

Middle Initial

Last Name *

Jr., II

MD, PhD

Address Line 1 *

Address Line 2

City *

State

Zip *

Province (if outside U.S.)

Country (if outside U.S.)

Phone Number *

Email Address *

Program Information

Applicant has completed IR fellowship training within the past *

Fellowship Institution *

PLEASE PROVIDE ONE OF THE FOLLOWING *

Department Chair Name

Fellowship Director Name

Application Materials

Manuscript *

CV *

Colored photo *

Max 10 MB

Contribution to IR Article *

You will need to have your department chair or fellowship director provide a letter of support attesting that you are the principal investigator of the research project. Instructions for submitting letters of support appear on the submission confirmation page.

You will have a chance to review your responses on the next screen before the application is submitted.

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