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SEF International Fellowship
Application for Senadhipan International Travelling Fellowship
Email *
Name *
Age *
Gender *
Nationality *
Passport Number *
Qualifications *
Present position *
Years of Experience *
Official Address *
Home Address *
Mobile no. *
Whatsapp no. *
Email ID *
Fields of interest *
Publications in the field of interest *
Are you a member of SEF? *
Are you a member of any of the following groups of SEF? *
Required
Have you been allocated SEF membership number? *
Approximate number of Minimally Invasive Surgeries done independently till date (Kindly attach link to your operative logbook in the last 3 years. Please segregate cases into basic and advanced) *
Have you ever attended SEF webinars so far *
If yes, how many? *
Approximate screen time of each webinar watched (Percentage of time watched of total screen time of the webinars)*                                                                          *Zoom settings have the mechanism to detect the details *
Device name given as your identity while logging in for the webinars *
Your usual location while logging in for the webinars *
Are you a subscriber of the SEF youtube channel? *
Do you agree to spread the activities of SEF to benefit a wider spectrum of patients? *
Do you agree to participate in any survey/ studies/ publications initiated by SEF? *
Vaccination status *
Your suggestions to improve the activities of SEF *
A copy of your responses will be emailed to the address you provided.
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