GSACEP Scientific Assembly Grant
The GSACEP Scientific Assembly Grant is intended to support GSACEP members in their academic pursuits, to encourage increased involvement in the Government Services Chapter and to cultivate future EM leaders.   Recipients receive free conference registration to ACEP Scientific Assembly (valued at $825 for staff physicians and $495 for residents).  Recipients are required to attend the GSACEP Board of Directors Meeting during the conference to receive recognition and foster familiarity with current EM issues important to the Government Services members.  
Connectez-vous à Google pour enregistrer votre progression. En savoir plus
Adresse e-mail *
Name *
Service & Rank *
Are you currently a resident or medical student? *
Please summarize briefly why you want to attend Scientific Assembly and why you should be considered and selected for this scholarship. 
Would you be willing to attend if there is no central funding to cover hotel and travel fees?       *
Unfortunately, this scholarship only covers conference registration (valued at $825 for staff physicians and $495 for residents).  Awardees will need to attend and pay travel expenses.  Please indicate if you plan on attending if central funding is not available.
Are you presenting at Scientific Assembly? *
If yes, what are you presenting (abstract, lecture, other)
Do you serve on an ACEP, GSACEP or EMRA committee? *
If yes, which one?
Do you have prior ACEP/ GSACEP service to the chapter or College?
Effacer la sélection
If yes, please specify.
Do you have prior hospital, military, or residency leadership? If yes, please describe your prior leadership roles.
Have you deployed before? *
If yes, where/when?
Envoyer
Effacer le formulaire
N'envoyez jamais de mots de passe via Google Forms.
Ce formulaire a été créé dans GSACEP. Signaler un cas d'utilisation abusive
Google Forms