SGM Cancer CARE Workshop Application

Application Procedure and Form: The deadline for applications is Monday, November 30, 2020 by midnight. Apply online using the form below.

Applications can be saved (for 30 days) before final submission by scrolling to the end of the application and clicking “Save and continue later.” After submission of the completed application, an email confirmation will be sent to each applicant indicating the successful receipt of the application.

Target Audience: Early-career researchers along the MD, DO, DrPH, and PhD career pathway, particularly faculty at the Assistant Professor or Instructor levels who have limited SGM cancer research experience but are in process of developing and launching their unique research agendas for their professional careers. Senior researchers, post-doctorates, residents, and fellows will have second priority for attending the workshop, if space permits

The workshop will target health and research professionals with MD, DO, PhD, or DrPH degrees, targeting individuals in the process of shaping their research agendas and interested in SGM cancer issues. Accepted applicants will be required and expected to attend all days of the workshop, fully participate in group activities, and complete all workshop evaluations.

SGM Cancer CARE Application

Name*
First Last
Email*
BNGAP username*
If you have not yet registered for BNGAP.org, please write "Not registered"
Completed Professional Degree*
Current professional role*
Professional Title and Department*
Primary Institutional Affiliation*
Other Institutional Affiliation*
Address*
City State / Province / Region ZIP / Postal Code Country
Race/Ethnicity*
Select all that apply
- Asian
- Black/African-American
- Hispanic/Latinx
- Native American/Alaskan Native
- White
- Prefer not to answer
- Other
Specify if Other
Gender Identity*
Specify if Other
What is your preferred pronoun?*
Sexual Identity*
Specify if Other
Please specify any dietary preferences or food allergies*
Number of years of experience in cancer research*
Number of years of experience in cancer research as a principal investigator*
Number of years of experience in SGM research*
Number of years of experience in SGM research as a principal investigator*
How many R01 grants as a principal investigator have you received?*
Upload your CV here (Word or pdf format)*
Describe any experience you have had conducting cancer research and/or research on SGM populations. Please include any significant experiences that are not described in your CV. [<300 words]*
Upload a research question(s)/idea(s), research proposal or Specific Aims page for development during our workshop. (Word or pdf format)*
Would you like to review your research question, research proposal or Specific Aims page with a research mentor at SGM Cancer CARE?*
Describe the skills you currently possess to complete research in the SGM cancer care continuum (prevention, screening, treatment or survivorship). [<300 words]*
Describe the skills you need to acquire to become a productive researcher in the SGM cancer care continuum (prevention, screening, treatment or survivorship). [<300 words]*
Describe your personal motivation (personal background or experience) for participating in this workshop. (<300 words)*
Describe any research resources available to you to conduct independent research and/or write grant proposals addressing the SGM cancer care continuum. [<300 words]*
Describe any community-based resources available to you to conduct independent research and/or write grant proposals addressing the SGM cancer care continuum. [<300 words]*
Add any additional comments you would like to share with us. [<200 words]*
I would like to be included in a directory of researchers interested in SGM cancer research.*
Specify any financial assistance you may need for SGM Cancer CARE workshop participation.*
Application Fee (Refunded if you are not accepted for workshop participation)*
- Application Processing Fee ($15.00)
Your total application processing fee
Please press submit to continue to Paypal to complete your registration.
$0.00
Comments
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Save and Continue Later

Contact sgmcancercare@gmail.com if you have any questions about this application.

Click Here for information about the SGM Cancer CARE Team

Click Here for information about the SGM Cancer CARE Workshop