Scholarship Application: Hep-DART 2023

HEP-DART 2023 Scholarship Application
HEP-DART 2023 is dedicated to providing scholarships to under-represented individuals, including women, and delegates from developing countries. Scholarships are also provided to young investigators, graduate students, and post-doctoral fellows as funding permits. To be eligible for the Young Investigator's fee waiver, one should be 35 years of age or younger and either be a current Master/PhD student or have obtained a MD/PhD degree in the last five years.

Please do not hesitate to email us at info@hepdart.com if you have any questions.
Personal Information
Full Name*

PrefixFirst NameMiddle NameLast Name
Professional/Academic Title*
Affiliation/Organization*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Country CodeArea CodePhone Number
Md/PhD Date Awarded

MonthDayYear
Date
Select as many of the following options that apply to you: *

I am 35 years of age or youngerI am a current Master/PhD student or have obtained a MD/PhD degree in the last five yearsI identify as an underrepresented individual or minorityI am a womanI am from a developing country, or a resource-limited setting
Have you submitted an abstract for this meeting? (If yes, please submit a copy)*

YesNo
Abstract

Browse Files
Please, submit a copy of the abstract if you have submitted an abstract for Hep DART 2023 Cancelof
Do you hold the following degrees?*

MDPhDMD/PhDNone of the above
Head Shot

Browse Files
Head shot may be used in IHE documents and promotions Cancelof
Copy of your CV*

Browse Files

Cancelof
Letter of Intent*

Browse Files
(max 400 words describing whether you have attended HEP DART before and why you would like to attend this year) Cancelof
Letter of Recommendation

Browse Files
(Not Required. max 500 words. ) Cancelof
Signature*

Clear
Date*

MonthDayYear
Date
The venue for HEP-DART 2023 is Hacienda del Mar Los Cabos, Mexico.

For more information, visit www.hepdart.com.

If you have any questions email us at info@hepdart.com.
Should be Empty:

HEP-DART 2023 Scholarship Application

Personal Information