Awards Subcommittee and Travel Scholarship Selection Panels Application Form

Awards Subcommittee and Travel Scholarship Selection Panels Application Form
Name*

First NameLast Name
Email*
example@example.com
City/Region/Country*
How many years have you been an ISOQOL member?*
Please indicate which positions you are interested in (select all that apply):*

Awards SubcommitteeStudent and New Investigator Travel Scholarship Selection PanelPatient Research Partner Travel Scholarship Selection PanelDeveloping Countries Travel Scholarship Selection Panel
If you selected more than one, please indicate any preferences.
Are you applying for a 2026 Travel Scholarship?*

Yes, I am applying for a 2026 travel scholarshipNo, I am not applying for a 2026 travel scholarshipOther
2026 scholarship applicants are not eligible to serve on the Travel Scholarship Selection Panels. Conflicts of interest will be considered on a case-by-case basis.
To the best of your knowledge, do you plan to be considered for any of the following ISOQOL awards in 2026?*

Yes, the Donna Lamping Emerging Leader AwardYes, the Outstanding Volunteer AwardYes, the Dennis Revicki Memorial AwardYes, the Annual Conference competition awards (i.e., Outstanding Poster Award, Student or New Investigator Oral or Poster Awards)No, I do not plan on being nominated or applying for any of these awards
Members of the Awards Subcommittee must adhere to any conflict-of-interest guidelines for subcommittee. Should a conflict of interest arise, subcommittee members will recuse themselves from awards selection discussions and decisions.
Upload a CV or Biosketch*

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