Canadian Hematology Society Abstract Award Application

This program offers research awards to hematology trainees in Canada in the categories of:

PHD AND POSTDOCTORAL
RESIDENTS AND FELLOWS

The John H. Crookston Award is presented each year for the best paper given by a resident.

The Stephen Couban Award is presented each year by the Canadian Hematology Society for the best abstract given by a Canadian resident in the area of leukemia or stem-cell transplantation.

Applicants must be a member of CHS.
Submissions are only valid with proof of abstract acceptance from ASH.

Please consider your application complete when you have received email confirmation that your complete application has been received. Only one abstract per individual will be accepted.

Deadline: October 31st @ 1600h ET.

Presentation to be made, in person, at the CHS Awards Gala in December during ASH. Recipients to present a 3-5 minute synopsis.

1. Award category for application *This question is required.

2. Contact Information *This question is required.

First Name
Last Name
Email Address
Tel. # (xxx-xxx-xxxx)
Degree (M.D., Ph.D., etc.)
Institution Name
Applicant Position at Institution
Street Address
City/Town
Postal Code

3. Research Supervisor Information (of the applicant)

First/Last Name
Title
Telephone #
Email

4. Research supervisor will attest that the applicant has made a significant contribution to the research abstract submitted herein. *This question is required.

5. Abstract Title

6. Date of Abstract Acceptance at ASH This question requires a valid date format of MM/DD/YYYY.

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7. Upload Abstract (Allowed types: png, gif, jpg, jpeg, doc, xls, docx, xlsx, pdf, txt, mov, mp3, mp4
Max file size: 500 KB). Please note, only one abstract per individual will be accepted *This question is required.

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8. Upload Photo(This can be skipped for now however all winners must be prepared to submit a colour photo and brief bio)

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9. Brief Bio