2019 Humanitarian Scholarship Application Form

2019 Humanitarian Scholarship Application

Please fill in the form below and upload appropriate documents. Contact us at ota@ota.org with any questions.
Full Name *

First (given) Name Last (family) Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Curriculum Vitae (CV)
All applicants must submit a CV. Please include the following information in your CV.

*Last (family) name
*First (given) name
*Work or Mobile Phone
*Email address
*Education: Medical school (name, location, year of completion)
Orthopaedic specialty training (at least one) (name of institution, location, year of completion)
*Current position and title
*Current employment (name of institution and location)
*Employment history in chronological order (names of institutions and locations)
*Teaching affiliations, if applicable, in chronological order (names of institutions and locations)
*Previous participation in scholarships, observerships or fellowship programs (names of programs, institutions and locations)
*Previous participation in other courses in the United States
*Recent publications and conference presentations
*Professional affiliations
Upload your (CV) *

Browse Files

Cancel of
Letters of Recommendation
All applicants must submit two letters of recommendation. At least one of the letters must be submitted by the applicant's training program director or an orthopaedic surgeon who has known the applicant for at least five years.

Below are guidelines for writing a comprehensive letter of recommendation.

Writers should include the following:

Duration of time and description of how they have known the applicant professionally.
Overview of the applicant's educational skills and capacity to learn new things.
Information pertaining to the applicant's leadership qualities.
Information pertaining to the applicant's potential to disseminate information obtained through the scholarship experience to his/her fellow colleagues.
Upload Letters of Recommendation *

Browse Files
Multiple files can be uploaded using the link above. Cancel of
Essay
Please state the most important improvement you would recommend for trauma care in your country and how you would personally hope to contribute to those improvements. Conclude by stating how the OTA Humanitarian Scholarship might aid your contribution. *
Should be Empty:

2019 Humanitarian Scholarship Application

Curriculum Vitae (CV)

Letters of Recommendation

Essay