ISVIR 2024 - BEST Trainee AWARD

ISVIR Membership No. not found

ISVIR Membership No. (Format : ISVIR-XXXX, C-XX or S-XX)*

Salutation *

First Name *

Middle Name

Last name *

Email *

Phone Number *

Gender *

Date of Birth *

City *

State *

Address *

Country *

Zip Code *

Designation *

Training Hospital/Institute *

Declaration Form *

Training Year *

Training End Date *

Hospital/Institute Address *

Download Sample Declaration Form

ISVIR Membership No. not found

Proposer ISVIR No. *

Name *

Phone Number *

Email *

Seconder ISVIR No. *

Name *

Phone Number *

Email *

Letter of recommendation from HOD (IR/ Radiology) *

Short CV including basic information and achievements *

List of Publication/ Oral Presentation/ Poster (Proof to be scanned and attached) *

Any previous national/ international award *

Upload Application Form *

Download And Fill Application Form

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