Guthkelch award

Guthkelch Award & Abstract Submission
Submit here to be considered for the SRHSB Guthkelch award. By submitting here, your abstract will also be considered for the general meeting - no need to submit twice.

Your Name

Credentials
MD/DO or those in training for one of these degreesPhD or those in a PhD training programOther

If credentials listed as "Other", please specify

Did you receive your terminal degree within the last five years or are you currently enrolled in a postgraduate training program?
YesNo

Position
Student-in-trainingPrimary Investigator

Affiliation

Your Email

Please provide the name and email address of your university tutor/mentor who we can contact to confirm your training status

Would you like to
Type in AbstractUpload Document

Body of the abstract must not exceed 2000 characters. If choosing only to upload your document, please include authors, and affiliations.

Abstract title

Additional Authors (each starting with numbered references for affiliations)

Additional Authors Affiliations (please number according to referenced authors above)

Abstract (2000 characters maximum)

Would you prefer to
Type in Personal StatementUpload Personal Statement

Personal Statement Instructions: Using 500 - 1500 words, detail your interest and/or involvement in the SRHSB, your motivation and research interest in the field of hydrocephalus and/or spina bifida, and your short- and long-term professional goals

Do you agree to publish your abstract in the meeting's associated journal?

YesNoUnsure (expect an email from us)

Do you agree to have your abstract and presentation published on this website in the members only area?

YesNoUnsure (expect an email from us)

Do you or any of the authors have any financial conflicts of interest to report? (Details of this are in Terms & Conditions link below)

YesNo

Please detail any conflicts of interest

Do you agree to our terms and conditions of the abstract and award? This includes confirming that you will be able to attend the conference if selected as a finalist. A link to the Terms & Conditions be found below this form.

YesNo