Conquer Cancer Foundation of ASCO Resident Travel Award for Underrepresented Populations

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Conquer Cancer Foundation of ASCO Resident Travel Award for Underrepresented Populations 2013 REQUEST FOR APPLICATIONS Last Updated: September 21, 2012 Conquer Cancer Foundation 2318 Mill Road, Suite 800 Alexandria, VA 22314 grants@conquercancerfoundation.org CONQUER CANCER FOUNDATION The Conquer Cancer Foundation is working to create a world free from the fear of cancer by funding breakthrough research, by sharing knowledge with physicians and patients worldwide, and by supporting initiatives to ensure that all people have access to high-quality cancer care. Working in close collaboration with a global network of top scientists and clinicians, as well as leading advocacy and research organizations, the Foundation draws on the passion and expertise of the nearly 30,000 oncology professionals who are members of its affiliate organization, the American Society of Clinical Oncology (ASCO.) For more information, visit www.conquercancerfoundation.org.

I. Purpose The Conquer Cancer Foundation of ASCO Resident Travel Award for Underrepresented Populations provides financial support for residents from underrepresented populations to attend ASCO s Annual Meeting. The intention of this award is to attract residents from underrepresented populations to a possible career in one of the oncology specialties. This travel award will allow the recipients to travel to the 2013 ASCO Annual Meeting, where they will have the opportunity to meet oncologists and to understand the career possibilities in the field of oncology. To be eligible, applicants must be of an underrepresented population as defined by the program eligibility criteria and be enrolled in an ACGME-accredited residency program required for future training in a cancer-related subspecialty and considering oncology as a career (e.g., Internal Medicine considering Med/Onc, Surgery considering Surg/Onc). Please note that residents already enrolled in oncology programs (i.e., Radiation Oncology) are not eligible. Candidates must be U.S. citizens, U.S. nationals or permanent residents. Candidates must demonstrate an interest in pursuing oncology as a career as well as a record of good academic standing. If selected, candidates must commit to attending the 2013 ASCO Annual Meeting held in Chicago, Illinois from May 31 June 4, 2013. At the meeting, awardees will have the opportunity to interact with oncology professionals who will be available to offer career guidance and assistance in navigating the Annual Meeting. Funding Available The Resident Travel Award for Underrepresented Populations includes a $1,500 travel advance, complimentary Annual Meeting registration, and access to the Annual Meeting housing block. Key Dates: Online Application Opens: September 24, 2012 Full Application Due: December 3, 2012 Notifications: March 2013 II. Eligibility To be eligible for the Resident Travel Award for Underrepresented Populations, applicants must meet the following criteria: Be enrolled in an ACGME-accredited residency program required for future training in a cancer related subspecialty (i.e., Internal Medicine considering Med/Onc, Surgery considering Surg/Onc) and considering pursuing an oncology career. Residents already enrolled in oncology programs (i.e., Radiation Oncology) are not eligible. Be a U.S. citizen, U.S. national or permanent resident; Be of an underrepresented population as defined by the program criteria. (For the purposes of this program, underrepresented population is defined according to the Association of American Medical Colleges definition, currently specified as those racial and ethnic populations that are underrepresented in the field of medicine relative to their numbers in the general population. Races/ethnicities that have been identified include but are not limited to: American Indian/Alaska Native, Black/African American, Hispanic/Latino, and Native Hawaiian/Pacific Islander.); and Have a record of good academic standing. III. Income Tax Liability Please note that the IRS requires reporting of payments over $600. Therefore, the $1,500 travel award to attend the 2013 Annual Meeting that you will receive under the RTA will result in taxable income, and you 2

will be responsible for payment of any federal or state taxes due. You will receive an information statement (IRS Form 1099-MISC) showing the total amount of the award under the RTA. Please consult a tax advisor regarding any further questions about taxes on the RTA funds you will receive. IV. Application Process Online Application All applications must be submitted in accordance with the requirements and instructions of this RFA. The online application opens on September 24, 2012 and must be submitted by 11:59PM EST on December 3, 2012. Please note that late applications will not be accepted. The most up-to-date information, including any updates to the RFA, and the link to the online application, will be posted at www.conquercancerfoundation.org/rta. To initiate an application through Easygrants, please go to https://grants.conquercancerfoundation.org. has Applicants who have not previously used Easygrants will be required to create an account. Creating an account allows you access to the RTA application. Please note that applicants are not required to complete the entire application at one time. The grant application can be saved and return to until the application deadline at 11:59PM EST on December 3, 2012. Once the grant application has been submitted, edits or revisions cannot be made. Applications are evaluated by a review and selection subcommittee of the Conquer Cancer Foundation. ASCO and the Conquer Cancer Foundation maintain the right to consider any relevant information in awarding the travel award. Among applicants who have submitted timely and complete applications and have been determined to meet the eligibility criteria, the following factors will be considered in determining which applicants will receive a RTA award: Demonstration of an interest in pursuing oncology as a career; Demonstration of leadership, volunteerism and/ or commitment to underserved populations or heath disparities; Letters of support; and Personal Statement. Full online applications must include the following sections: 1) Contact Information 2) Applicant Information 3) References 4) Current Resume 5) Personal Statement 6) Proof of US Citizenship and Residency 7) Travel and Academic Verification Form 8) Letters of Recommendation Contact Information Name Educational Institution Address Phone Email Please note that primary address, phone, and email are required in the Contact Information form in Easygrants and that the Primary box must be checked. Applicant Information Degree (At least one Post-Baccalaureate Degree is required) Field of Research Training 3

Field of Clinical Training (At least one Field of Clinical Training is required) Gender Race/Ethnicity References The RTA application requires applicants to submit at least two (2) letters of recommendation. (For more information about the letter requirements, please see the Uploads section of this RFA.) For this section of the application, add the following contact information for all of your RTA references: Name Project Role Please specify if your reference is your: o Academic Advisor or Instructor o Mentor o Program Director o General Reference Phone Number Email Uploads Uploads can be in PDF or MS Word although PDF format is preferred to ensure proper conversion. Uploaded documents should not be password protected or they may not convert properly. Resume (Upload) Applicants must upload a current resume. Please ensure that your resume includes any applicable information pertaining demonstration of leadership, volunteerism, and/or commitment to underserved populations or health disparities. Personal Statement (Upload 5 Page Maximum) Applicants must upload a signed and dated personal statement. Applicants will be scored based on the content of the personal statement. In the personal statement, you should describe your: Interest in pursuing a career in clinical oncology; Future career goals in the field of oncology; Demonstrated leadership, volunteerism and commitment to underserved populations or health disparities. Proof of US Citizenship or Residency (Upload) Applicants must upload documentation of evidence of U.S. citizenship, status as a U.S. National or permanent resident. Documentation can include a copy of any one of the following: Certified birth certificate issued by the city, county or state; U.S. Passport; or Naturalization Certificate. Travel and Academic Verification Form (Upload Template Included in Application) Applicants will be required to submit the RTA Travel and Academic Verification Form to verify that the applicant is in good academic standing and has permission to travel to the 2013 ASCO Annual Meeting. Letters of Recommendation (Upload) Applicants must upload at least two (2) Letters of Recommendation: 4

One recommendation from the applicant s Residency Program Director; and An additional recommendation from someone who has supervised or overseen the applicant s academic or professional work. Letters of recommendation must be written on letterhead and include the following: Reference Contact Information, including: o Name o Title A statement of the writer s relationship to you; An illustration of why you are an outstanding candidate for this award; A description of how this program would benefit your overall career development; and V. Application Submission The submitted online application, including all Reference Letters, must be received before the deadline of 11:59PM EST on December 3, 2012. Please note that applicants are encouraged to submit early as no technical help will be available after 5:00PM EST. VI. General Information The online application website is: https://grants.conquercancerfoundation.org Please visit www.conquercancerfoundation.org/rta for the most up-to-date version of the application details and the link to the online application. Applicants will be notified if they have been selected to receive the Resident Travel Award for Underrepresented Populations beginning in March 2013. If you have questions about the Resident Travel Award for Underrepresented Populations or the application process, please email grants@conquercancerfoundation.org. 5