Gillingham Pan-American Fellowship Program Application

Gillingham Pan-American Fellowship Program

  • Date Format: DD slash MM slash YYYY
  • Current Training Program

    Complete contact information of the Department Chair or Program Director who is recommending you to for this scholarship.
  • First Name, Middle Initial, Last Name(s), Degree(s) (MD, PhD)
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Accepting Program

    Name of the Institution to which you have been/will be accepted. Make sure to include the name of the Program Director who will be supervising your training and as well as dates of the training program.
  • First Name, Middle Initial, Last Name(s), Degree(s) (MD, PhD)
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Application Materials

    Please upload all of the supporting documents required for you application. Max size per file is 128 MB
    1. Photo
    2. Curriculum Vitae (CV)
    3. Letter of interest
    4. Letter of recommendation
    5. Confirmation of acceptance by an accredited training program
    OR Copy of the letter of application to an accredited training program with acceptance letter to be submitted by February 1 to info@paao.org
    6. Photocopy of passport
  • Accepted file types: doc, pdf, jpg, png.
  • Agreement

    Please read and check each box below confirming you agree.
  • By typing my name here I am confirming the above statements are true and it will act as my full signature.
  • Date Format: DD slash MM slash YYYY

Disclaimer: Employees of the Pan-American Association of Ophthalmology (PAAO), Pan-American Ophthalmological Foundation (PAOF), members of the PAAO Executive Committee, members of the PAOF Board of Directors, their immediate family members and members of the same household, whether related or not, are not eligible to apply for scholarship/fellowship funding. All scholarships are subject to federal laws and regulations and are void where prohibited by law or regulation. Applicants agree to abide by the terms of these official rules and by decisions of the Review Committee which are final and binding on all matters pertaining to the scholarship/fellowship. The PAAO & PAOF reserve the right to disqualify any applicant that they determine, in their sole discretion, to be ineligible to participate in the scholarship/fellowship program. Individuals who have previously received travel awards/scholarship/fellowship funding are ineligible to apply for additional awards/ funding.