Application Form

Please complete this form to start the process of applying for the Victoria Cohen scholarship for aspiring ocular oncologists. We may contact you for more information.

Note:  In order to be considered for an award you need to be able to provide evidence of acceptance to a fellowship program.

Before you start you should have the following documents ready to upload:

  • Proof of fellowship (Letter from Director of institute)
  • Your CV / Resume

Both documents should be uploaded in either Microsoft Word or PDF formats.

Personal Details:
Education Details:
Fellowship Details
Fellowship Duration
Once your fellowship is complete
Where will you practice when you are done?

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