Foundation for Head and Neck Oncology Fellowships 2018-2019
Last Date for application July 15, 2018
Results at the 18th FHNO Annual Meeting in Kolkata, October 25-28, 2018
FELLOWSHIP beginning date
Travel fellowship and Shireen Gazdar (6 months) : on or before 1st June 2019
Shireen Gazdar (1 year) : On or before 1st Jan 2019
Fellowship Applied for ( can select more than one)
Name
Your answer
Surname
Your answer
Year of Qualification
Your answer
Highest Academic Qualification (MD/MS)
Your answer
Are you a FHNO Member (Only FHNO members eligible)
Membership Number
Your answer
Email ID
Your answer
Contact Number (Std Code and Number)
Your answer
Current Position (Registrar /Fellow/Practise/Other)
Your answer
Current Place of Work
Your answer
Experience in Head Neck So Far
Your answer
Number of pubmed indexed publications
Your answer
Achievements in Head Neck
Your answer
What are your specific Objectives from the Fellowship
Your answer
How would this add to advancement of Head-Neck Oncology in your training/ environment/ institution?
Your answer
Any specific institutions you may wish to visit? (Not Mandatory)
Your answer
Number of times previously applied for the Fellowship
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