2026 LSRS Hands On Surgical Techniques Course Application
Scholarship Application for U.S. Based Senior Residents and Fellows, Application Deadline: July 1, 2026
Course Date: October 22-24, 2026
Medical Academic Center || Carmel, IN
Applicant Name
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First Name
Last Name, Degree
Applicant Email
*
example@example.com
Please indicate specialty:
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Orthopedics
Neurosurgery
Current Training Program
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Applicant Institution
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What year in your program will you be at the time of the course (October 2026)?
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PGY-4
PGY-5
PGY-6
Fellowship
Other
Please indicate secondary or sub-specialty if you have one:
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Is this your first time attending a hands-on course?
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Yes
No
How/where did you hear about this course?
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Tell us why you wish to attend the 2026 LSRS Hands on Surgical Techniques Course:
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Please tell us about your current research projects?
*
Name of current department Chair or Program Director:
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First Name
Last Name
Email of current department Chair or Program Director:
*
example@example.com
Letter of support from current department Chair or Program Director:
*
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All accepted scholarship recipients will be asked to submit TWO case studies in advance of the course for discussion.
*
I agree to submit TWO case studies in advance of the course.
Upload Current CV:
*
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Accepted scholarship recipients will receive complimentary registration, hotel stay, and reimbursement for travel*.
*Reimbursement for airline travel or mileage if within driving distance only. Reimbursement will not include incidentals, travel to/from airport to hotel, and other miscellaneous expenses.
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