SDMS Educational Foundation

Awards Entry Form

Please mark the award for which you are submitting an entry. This form must be returned with the award submission and must be received by the Foundation by June 30.
  COMPLETE ENTRY FORM AND PRINT  
Award (select one): Bracco Diagnostics Research Award
Bristol Myers Squibb Contrast Imaging Award
Donald Milburn Service Award
GE Healthcare Excellence in Sonography Award
Graduate Research Award
Medison 3D Sonography Award
Philips Imaging Award
SonoSite Hand-Carried Ultrasound (HCU) Award
SDMS Member #:
First Name:
Last Name:
Credentials:
Title:
Address:
City:
State/Province:
Zip/Postal Code: -
Country:
Phone/FAX: [Home]
[Work]
[FAX]
Email:

I have reviewed this application carefully. By my signature, I certify that the information in this and supporting documents is accurate to the best of my knowledge. I also understand that if awarded, my final work will be submitted for review and possible publication in the Journal of Diagnostic Medical Sonography

Signature:____________________________________________ Date: _______________

All submissions must be received in the Foundation office no later than June 30. All submissions become the property of the SDMS Educational Foundation and will not be returned without a written request. If you have any questions, please contact the SDMS Educational Foundation at 2745 Dallas Pkwy, Ste 350, Plano, TX 75093-8730. You may call with your inquiry at 214-473-8057 or email foundation@sdms.org.