Fellowship Application

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Please submit your application for the 2011 CSNS Fellowship Positions! (Deadline: March 21, 2011)

MessagePlease note that the application submission form has been experiencing intermittent technical errors. If you are unable to submit your application, please email it and your CV to BINGAMB@ccf.org. We apologize for the inconvenience.
Application will be sent to:
William E. Bingaman, MD
Vice Chair, Neurological Institute
Cleveland Clinic
Cleveland, Ohio
(216) 444-9058 office
(216) 444-0343 fax
BINGAMB |at| ccf |dot| org

First Name
Last Name
Email
Program
Post Graduate Year of Training
Address
City
State
Zip
Phone
Fax
AANS Member?noyes
CNS Member?noyes
Neurosurgical Leadership Experience
Neurosurgical Socioeconomic Experience
Prior CSNS Experience
CSNS Contacts
Upload CV
Miscellaneous Comments
In 200 words or less, answer the following:
What qualifications or experiences have you had which might enable you to take fuller advantage of your time as a CSNS socioeconomic fellow?
How did you become interested in this fellowship and how do you feel it might change or enhance your career in Neurosurgery?
I am availabile and know that I must attend two CSNS meetings.
I know that I will need to send my Program Director's signature indicating awareness of meeting attendance requirements.
no
yes
 
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