UAA AURC 2024

UAA AURC 2024
(End Date for Submission : 12th April 2024)

Please attach a recent coloured photo of yourself * (max 2 MB)

*jpg, jpeg, png

First Name *

Last Name

Date of Birth *

Gender *

Name to appear on the Certificate of Attendance *

Training Center/University or Hospital *

Mailing Address including City *

Country *

Association *

Email *

Year of Residency Training Entry *

Expected Year of Graduation from Residency Training *

UAA Individual Membership No. (if applicable) *) Please go to UAA Website www.uaanet.org to apply as UAA Individual Member if you are not a member yet.

Sub-specialty of Interest * (Choose Max. 3)

BPH

Oncology Urology

Urolithiasis

Pediatric

Andrology

Renal transplantation

Awards/Honors/Scholarship

Publications – if any (Please give the details of all the authors, title, journal name, year, DOI [Max 5])

Authors	Title	Journal Name	Year	DOI

Scientific Presentation – if any (Please give the details on the title of the abstract, years, and conference name, for Poster/Podium presentation [Max. 5])

Abstract Title	Years	Conference Name

Most recent 5 Physical or Virtual Conferences/workshops attended

Penalty
Applicants who have been nominated must attend the session in person. Failure to attend without reason deem valid by UAA will be penalized at a cost of USD500.00, payable to Urological Association of Asia.

I agree that the information I provided is true and accurate, and would like to submit this application

Awards/Honors/Scholarship

Publications – if any (Please give the details of all the authors, title, journal name, year, DOI [Max 5])

Scientific Presentation – if any (Please give the details on the title of the abstract, years, and conference name, for Poster/Podium presentation [Max. 5])

Most recent 5 Physical or Virtual Conferences/workshops attended

Penalty Applicants who have been nominated must attend the session in person. Failure to attend without reason deem valid by UAA will be penalized at a cost of USD500.00, payable to Urological Association of Asia.

Penalty
Applicants who have been nominated must attend the session in person. Failure to attend without reason deem valid by UAA will be penalized at a cost of USD500.00, payable to Urological Association of Asia.