Research.net Powered Online Survey

ISLH 2020 MENTORSHIP PROGRAM APPLICATION

APPLICATION GUIDELINES - DEADLINE FEBRUARY 7

Applicants must be from resource-poor areas including Eastern Europe, Asia, Africa, and South America.

1. Applicants must submit a proposed project.
- Proposed projects could include the development of reference ranges.
- Applying and/or learning a new laboratory practice skill (e.g. multiparameter flow cytometry).
- Learning to write a successful publication or grant application.

2. Applicants must submit a letter of support from their home institution.

You will need to upload items these 2 items at the end of this application form.

PROGRAM OUTLINE

Part 1: Attendance at ISLH 2020 in Melbourne, Australia
- Participation in educational workshop or guidelines workshop (depending on applicants focus).
- Participation in mentorship program welcome meeting.
- Daily 15 minute meeting with mentor while at conference.

Part 2: Online Remote Mentorship
- Monthly teleconference meetings.
- Mentor will provide counsel and networking guidance on research project.

Part 3: Attendance at ISLH 2021 in New Orleans, USA
- Participation in educational workshop.
- Participation in mentorship program welcome meeting.
- Daily 30 minute meetings with mentor while at conference.
- Abstract submission of project progress for either an oral or poster presentation.

*All travel expenses, registration fees and teleconference fees will be covered by ISLH.

Question Title

* Please review the above program guidelines and outline. Indicate below that if selected, you will be able to attend both the 2020 meeting in Melbourne and 2021 meeting in New Orleans as well as be available for monthly calls with your assigned mentor.

Yes, to all of the above

No, this program is not right for me

Question Title

* Please enter your contact details below.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* What kind of facility do you work in?

Reference Lab

Hospital Laboratory

Academic Institution

Other (please specify)

Question Title

* Please describe your position.

Laboratory Technologist

Laboratory Scientist

Laboratory Physician

Laboratory Director

Other (please specify)

Question Title

* Please indicate your professional qualifications or degrees.

Question Title

* Please summarize the laboratory testing that you oversee in your role.

Question Title

* Please describe the level of your experience.

New to the Field

Beginner (Less than 2 years of experience)

Intermediate (2-5 years of experience)

Advanced (More than 5 years of experience)

Question Title

* Please provide a brief summary of the healthcare challenge that you would like to help address with the support of a mentorship award.

Question Title

* Which regional organizations do you have available for support in the field of Laboratory Hematology?

Question Title

* Please provide a link to the website of your facility.

Question Title

* Please check the area(s) of laboratory hematology that you wish to be the focus of your mentorship experience.

Cellular Analysis

Coagulation

Flow Cytometry

Molecular Analysis

Morphology

Platelets

Red Cell Analysis and Hemoglobinopathies

Standards and Quality Assurance

Other (please specify)

Question Title

* Please provide a short statement about how participation in this program will enhance your training or practice in laboratory hematology and the potential impact at your current laboratory/institution/facility.

Question Title

* Upload your proposed project.

PDF, DOCX, DOC file types only.

Choose File

Question Title

* Upload a letter of support from your home institution.

PDF, DOCX, DOC file types only.

Choose File