Fellows Scholarship Application

Fellows Scholarship Application

Please fill out the following in its entirety to be considered for a scholarship to the 2025 COA Conference. Mandatory attendance is required to satisfy a scholarship award. Round-trip travel and hotel are covered by COA. Other expenses and ground transportation are not covered and are non-reimbursable.

Fellowship Year*

Select

First Name*

Last Name to include credentials*

Email*

Personal Email*

Mobile Number*

Phone

Name of Fellowship Program*

Full attendance at all events noted below is mandatory for a scholarship reward.

Conference - April 29-30, 2025
Fellows Networking Reception & Dinner - April 29, 2025

By checking the box below, you agree to attend all mandatory Conference events. If you do not agree or have any questions, please reach out to Tracey Banks at tbanks@COAcancer.org.

I acknowledge and agree with the requirements noted above.*

Are you interested in attending the COA Board of Directors Meeting on Monday, April 28?*

If yes, your presence will be required for the entire duration of the meeting which normally runs from 7:30 a.m.-3:00 p.m. As space is extremely limited, showing interest does not automatically approve your attendance to the Board Meeting. You will be notified via email letting you know whether or not you have been approved.

Yes

Comments

If your application is approved, you will receive an invitation with a registration link that will need to completed as soon as possible.

If you would like a copy of your submitted request, check the box by "Send me a copy of my responses" and re-enter your email.

Send me a copy of my responses

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