SUMO Clinical Oncology Conference Stipend Application

The SUMO Board will award 20 Conference Stipends in the amount of $500 each to offset the cost of hotel and travel expenses to attend the SUMO Clinical Oncology Conference on Saturday, September 23, 2023, at the Hyatt Centric - Park City. Stipend recipients will be required to book overnight accommodations at the Hyatt Centric-Park City through the SUMO room block. Stipend payments will be distributed to recipients post-conference. A W-9 will be required to receive the stipend payment.

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* 1. Contact Information

Name

Institution Name

Home Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Mobile Phone Number

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* 2. Have you attended the SUMO Clinical Oncology Conference in the past?

Yes

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* 3. How will attending the Clinical Oncology Conference improve overall level of expertise and patient care?

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* 4. If awarded a Stipend, you will be required to complete the following items in order to receive your Stipend reimbursement. Failure to complete these items will result in forfeiture of your Stipend.
- Stipend recipients are required to attend the full conference. Partial attendance will forfeit your Stipend reimbursement.
- You will be required to make your own hotel reservation with the Hyatt Centric-Park City using the SUMO Room Block.
- Upon arrival at the Conference, you will be required to sign in at the registration desk.
- At the conclusion of the Conference you will be required to sign out at the registration desk.
- Completion of a post-conference survey.
Indicate your acceptance of these terms below.

I have read and agree to all the Stipend requirements as listed

I do not agree with the Stipend requirements as listed