BCRF Trainee Travel Awards – 2025 ASTRO Annual Meeting – American Society for Radiation Oncology (ASTRO)

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Applicant Data

Name

Institution

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Professional Level

Professional Level MS – medical student GS – graduate student PD – post-doctoral fellow PGY – resident

Year in Training

Degree

Phone Number

Date of Birth

Mailing Address

Institution email address

Personal email address

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Institution And Contacts

Program director/mentor’s name

Program director/mentor email address

Department chair’s name

Department chair’s email address

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Membership Status

Member Type

Member ID

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Applicant Demographics

Gender

Radio Buttons Gender 1 Female Male Non-binary Transgender man Transgender woman Prefer not to say

Other/Prefer to self-describe – please indicate

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Are you of Hispanic, Latino or Spanish origin?

Radio buttons No Yes: Mexican, Mexican American, Chicano Yes: Puerto Rican Yes: Cuban Yes: Other (for example, Argentinian, Colombian, Dominican, etc.)

Hispanic Other Please Indicate

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What is your race?

Race1 White Black or African-American Native Hawaiian

Race2 Guamanian or Chamorro Samoan American Indian or Alaska Native

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If you selected American Indian or Alaska Native, please indecate name of enrolled or principal tribe.

Enrolled or Principal Tribe

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Other Pacific Islander (for example, Fijian, Tongan, etc.)

Other Pacific Islander

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Asian

Radio buttons - Asian 1 Indian Chinese Japanese

Radio buttons Asian 2 Korean Vietnamese Filipino

Other Asian

Two or more races

Country of Citizenship

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Are you from a disadvantaged background?

Disadvantaged Background Yes No

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Do you self-identify as a person with disabilities?

Diabilities Yes No

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ASTRO Attendance

Prior ASTRO attendance:

Prior Attendance Yes No

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If yes, what year did you attend ASTRO?

Attendance year

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Did you submit an abstract for the ASTRO 2025 meeting? If yes, title of your submission

Submission Title

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Have you participated in the Medical Student Fellowship program?

If yes, what year did you participate?

Fellowship Year

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Application Documents

Statement of Interest

Please describe your academic and personal accomplishments, efforts towards improving health care access and how receiving this travel award will assist you in reaching your educational and professional goals.

Statement of Interest

Please select a file

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Letter of Recommendation

Please upload the letter from your Program Director/Mentor or Department Chair.

Letter of Recommendation

Please select a file

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CV

Attach your complete curriculum vitae (including all past and current funding from any source). Limited to two pages.

Please select a file

Attend

Experience

Learn

Exhibit Hall

BCRF Trainee Travel Awards Application

Applicant Data

Institution And Contacts

Membership Status

Applicant Demographics

ASTRO Attendance

Application Documents

Statement of Interest

Letter of Recommendation

CV

TERMS OF USE & PRIVACY POLICY

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