Application

Emerging Nation Leadership Development Scholarship Application

This scholarship provides financial support to bring a neurodiagnostic professional with leadership skills from an emerging nation to attend the ASET Annual Conference.

The goal is to provide unique opportunities to develop important skill sets and to network with the ASET community, building resources and knowledge which can be shared with fellow technologists in emerging nations. The experience will foster establishing connections, learning from experts, and support sharing innovative work on a global stage to improve patient care.

Before you begin your application, please ensure you have the following documents readily available:

Letter of Reference: A letter of recommendation from your employer
Travel Readiness: Proof of your ability to secure a passport, visa, and any other necessary travel documentation by April 1st

Quick Facts

Eligibility: Neurodiagnostic professional with leadership skills from an emerging nation
See full eligibility criteria
Covers: Airfare, registration, hotel stay, travel reimbursement, and a per diem
Deadline: October 31st for attendance the following year

Complete the Application Below

Application currently closed. Please check back in September.

Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Employer/Institution

Employer/Institution Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Position/Title

established... strengthen resources

Years in Neurodiagnostic Profession

Neurodiagnostics Credentials Obtained

Eligibility Confirmation

I reside...

I reside in a developing country or underrepresented community.

I am an established...

I am an established and recognized neurodiagnostic professional within my region.

I am able to secure...

I am able to secure all required documentation to enter the United States (passport, visa, references).

I agree to submit...

I agree to submit a poster presentation at the ASET Annual Conference if selected.

Statement of Purpose

Community Impact Statement

Poster Presentation Commitment

Please provide a proposed title or theme for your poster presentation at the ASET Annual Conference:

Please Note: A lecture or program presentation are acceptable alternatives if organized with ASET staff. Abstracts are due by March 1st. Learn more about submitting your abstract.

Employer Verification

Please attach a signed letter of reference from your employer confirming your current role and length of employment.

Allowed File Types: .doc, .docx, .rtf, .pdf

Applicant Declaration

I certify that the information provided in this application is accurate. I understand that if selected, I must provide all documentation for U.S. entry, and that the award will be void if I am unable to attend the Annual Conference.

Signature

Clear Signature

Date

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