SCAROP 2014 FINANCIAL SURVEY ORDER FORM The Society of Chairs of Academic Radiation Oncology Programs (SCAROP) and the American Society for Radiation Oncology (ASTRO) have conducted this survey in collaboration with Krause PC, a Denver Certified Public Accounting firm, for the fourth time. The 2014 SCAROP Financial Survey (published with 2013 and 2014 information) is a member census and primarily represents radiation oncology departments of United States medical schools. This report presents significant indicators valued by leaders of academic radiation oncology clinical services in maintaining a viable operation. This information allows users to evaluate and compare faculty and nonfaculty compensation and bonuses, along with department funding resources. Cost per copy: $200 Participating Institution $400 Nonparticipant Contact/Payment Information BILLING ADDRESS BILLING AND SHIPPING ADDRESS First Name Last Name Institution Address Country Zip City Email State ASTRO ID Phone SHIPPING ADDRESS IF DIFFERENT FROM BILLING ADDRESS First Name Last Name Institution Address Country Zip City Email State Phone ASTRO ID Method of Payment Enclosed is check #___________________ in U.S. funds and made payable to ASTRO. Charge to the following: EXPIRATION DATE CARDHOLDER’S NAME (AS IT APPEARS ON CARD) SIGNATURE Alpert School of Medicine at Brown University /Lifespan Brigham & Women's / Mass Gen Harvard Case Western Reserve University Cedars-Sinai Medical Center City of Hope National Medical Center Duke University Hospital East Carolina University Brody Emory University Henry Ford Hospital Jackson Memorial Hospital Johns Hopkins University McGaw Medical Center of Northwestern University Medical College of Wisconsin Medical University of South Carolina Memorial Sloan Kettering Cancer Center New York University School of Medicine NSLIJHS-Hofstra North Shore LIJ Oregon Health and Science University Princess Margaret Hospital Rush University Medical Center Rutgers Robert Wood Johnson Stanford University Stony Brook University Hospital SUNY Upstate Medical University Temple University Hospital/Fox Chase Cancer Center The Ohio State University Hospital Thomas Jefferson University Tufts University School of Medicine/Tufts Medical Center UCLA Medical Center University of Alabama at Birmingham University of Arizona University of California San Diego University of California, Davis Health System University of California, San Francisco University of Colorado University of Florida University of Iowa University of Kentucky College of Medicine University of Louisville University of Maryland University of Michigan University of Minnesota University of North Carolina Hospitals University of Pennsylvania University of Rochester University of South Florida University of Southern CA / LAC+USC University of Texas Health Science Center, S A University of Texas MD Anderson University of Texas Medical Branch University of Utah University of Wisconsin Virginia Commonwealth University Wake Forest University School of Medicine Washington University/Barnes-Jewish Hospital William Beaumont Hospital Yale-New Haven Medical Center MAIL OR FAX YOUR COMPLETED FORM TO: CREDIT CARD NUMBER CARD SECURITY CODE (CSC) SURVEY PARTICIPANTS: DATE American Society for Radiation Oncology PO Box 418075, Boston MA 02241-8075 703-286-1571 Attn: Erick Granados