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ASSOCIATION OF PROFESSORS OF GYNECOLOGY AND OBSTETRICS
2025-2026 APGO Academic Scholars and Leaders Application
Name
*
First
Last
Suffix
I've Been an APGO Member Since
*
Institution
*
Business Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
*
Email
*
My Local Mentor Will Be
*
Mentor Email
*
Major Educational Responsibilities
*
Upload Supporting Documents
*
Max. file size: 50 MB.
Please submit one .pdf containing all application documents: Current curriculum vitae Statement of Department Chair Commitment and Support (download form from APGO website). A separate cover letter from your Chair stating what they expect the value of your participation will be to the university/or institution. A personal statement (limited to two pages, double-spaced) including why you want to participate in this course, a statement of agreement to complete course requirements, and how you intend to use the knowledge and skills gained from this experience. If you have applied before, a statement of what you have accomplished since your last application.
Additional Upload, if needed
Max. file size: 50 MB.
Board Certification Status
Board Certified
Board Certification Scheduled for 2024
Not Board Certified
Clerkship Directors' School 101 & 201 Attended
2022 (virtual)
2023
2024
Clerkship Directors' School 301 Attended
2022
2023
2024
APGO Faculty Development Seminar 2022 (virtual)
Attended
Presented
APGO Faculty Development Seminar 2023
Attended
Presented
APGO Faculty Development Seminar 2024
Attended
Presented
CREOG & APGO Annual Meeting 2022
Attended
Presented
CREOG & APGO Annual Meeting 2023
Attended
Presented
CREOG & APGO Annual Meeting 2024 (or will attend)
Attended/Will Attend
Presented/Will Present
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