2015 SGO INTERNATIONAL SCHOLAR TRAVEL GRANTS
The SGO is pleased to offer three (3) International Scholar Travel Grants to assist multidisciplinary early
career professionals involved in the prevention, research, treatment or care of gynecologic cancers. The
scholarship provides up to $3,300USD for travel and lodging expenses to attend the SGO Annual
Meeting on Women’s Cancer™ in Chicago, Illinois, March 28-31, 2015.
AWARD AMOUNT
Up to $3,300 USD for travel and lodging expenses to attend the SGO Annual Meeting. Scholarship
applications will be accepted beginning September 15, 2014 and close November 14, 2014.
CONDITIONS AND CRITERIA

Awards will be multidisciplinary early career professionals either;
o
Five (5) years from fellowship or apprenticeship OR
o
Five (5) years from residency OR
o
Up to ten (10) years from graduation

Demonstrate strong interest in prevention, research, treatment or care of women with
gynecologic cancers

Past record of scholarly work and promise of future scholarly accomplishments

Documented academic or clinical activity in the prevention, research, treatment or care of
women with gynecologic cancers

Posters or abstracts delivered at the SGO Annual Meeting are encouraged but not required

Awardees must have sufficient command of the English language to benefit from attendance at
a major international scientific meeting.

Submissions from under-represented countries are encouraged.
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POST-REPORT & COMPLIMENTARY MEMBERSHIP

A 300-word report is required after the award is completed. SGO may post some of the
information from the report in its publications.

Awardees are extended one (1) year of complimentary membership upon award and another
complimentary year based on receipt of submitted post-report for a total of two (2) years.
INTERNATIONAL SCHOLARSHIP APPLICATION
Please return this signed form to Membership@SGO.ORG
I.
SCHOLAR CONTACT INFORMATION
Family Name:
First Name:
Gender:
Permanent Address:
E-mail Address:
Primary Phone:
Secondary Phone:
Country of Citizenship:
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II.
EMERGENCY CONTACT
Family Name:
Relationship:
First Name:
Address:
E-mail Address:
Primary Phone:
Secondary Phone:
Country of Citizenship:
III.
LANGUAGES AND EDUCATION
List the languages you speak (including native language) and your proficiency level.
Language
Proficiency
List the two educational institutions you have attended most recently.
Name of Educational
Institution
IV.
Country
Field of Study
ACADEMIC PROGRAM DETAILS
Name of Institution:
Location (City and Country):
Institution’s Website (URL):
Academic Program:
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Degree Received
and Date
Official Language(s): _______
Anticipated Start Date: ______________________________________________
Anticipated End Date: _______________________________________________
V.
AREA OF FOCUS AND GOALS
Which of area(s) of focus in women’s cancer or oncology is the program of study aligned?
Prevention
Research
Treatment
Care
Explain how your program of study relates to your selected area(s) of focus:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Describe your educational and professional goals, including your career plans, and how attendance at
the SGO Annual Meeting on Women’s Cancer will help to advance these goals:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What aspect of women’s oncology will your work address during or after completing this program?
How will your work contribute to addressing this need on a long-term basis?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
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Signature:
Date:
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Annual Meeting on Women’s Cancer™ International Scholarship
Acceptance of Conditions Form
(To be completed by Awardee)
Name: ________________________________________________________________________
Awardee – PLEASE PRINT

I agree to be present at the 2015 SGO Annual Meeting on Women’s Cancer™ and attend all
required sessions and activities specified by my hosts - the SGO International Committee.

I agree that one (1) year of complimentary membership will be granted to me upon acceptance
as an International Scholar. I also understand that a second (2nd) year of complimentary
membership will be extended to me based on SGO’s receipt of a post-report.

I agree to submit a written final report to the Foundation for Gynecologic Oncology about my
experience as an International Scholar within two (2) months after the end of the Annual
Meeting. The report should be limited 300-words pages Arial 11 pt. font with 1” margins. SGO
may post some of the information from the report in its publications.

If my abstract is selected for inclusion at the SGO Annual Meeting, I will agree to make mention
of the International Scholar Travel Grant prior to its presentation.

I will acknowledge the award of this International Scholar grant in any publication presenting
work resulting from this grant support.

I will agree to notify the Foundation of any abstracts, reports, manuscripts, or any other form of
published information, e.g., electronic media, book chapters, videos, tapes, etc. that were
supported in whole or in part by this grant.

I hereby grant permission to use my likeness in photography for publications, promotional
purposes, website, media press releases and coverage, and any other such purpose on behalf of
the SGO International Scholar Travel Grant program and the Annual Meeting on Women’s
Cancer.

I understand that I will not receive compensation for the use of this likeness in any form.
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Signature: ____________________________________ Date: _____________________
Awardee
Signature: ____________________________________ Date: _____________________
International Committee, Chair
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