Fellows at CARVE Application

Application details

A maximum of 25 fellows and/or residents will be invited to participate in the Fellows at CARVE (see agenda). Interested vascular surgery, interventional radiology and cardiology fellows, and senior-level residents are invited to submit an application to be considered for attendance.

1. Statement of Interest

Reason(s) you would like to attend Fellows at CARVE
Summary of experience and devices used to date
Topics of interest
Other information you deem important

2. Curriculum Vitae (CV)

3. Case report

Submit one case report, no more than 400 words, in abstract format. While photos or illustrations are permitted, they will count as 50 words per photo or illustration, two maximum.
Invited attendees must submit Powerpoint presentations by January 21, 2024.
Invited attendees will present their cases on February 14, 2024. Please note that a presentation is required for travel and lodging reimbursement.

Please complete the application below, attaching all required documents, by December 11th, 2023.

Fellows Application

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Personal Email*
Institution*
Program Director*
Type*
Specialty*
PGY*
How did you hear about Fellows at CARVE?*
Future Career Plans*
- Academic
- Private Practice
- Community Practice
To support the educational grant reporting requirements: NPI#*
Institution Employer ID # (EIN)*
Professional Phone #*
Professional Email*
* Maximum file size is 50MB each and the maximum total of all files is 150MB
Drop files here or

Max. file size: 50 MB.
If you have technical issues, please contact Chris Anderson canderson@mplsrad.com or 763-398-2212.