Elevate Retreat
Positioning Physicians Underrepresented in GI for Success
NOMINATION FORM

 

  • If you are nominating more than one individual, please submit one form per person and indicate your order of preference.
  • Self-nominations are accepted.
  • Complete and submit the required documentation by Friday, July 19.

ASGE will cover travel and hotel costs to attend the Elevate Retreat at ASGE August 23-24, 2024. Meals will be provided during the retreat.

Nomination Being Made By:

Nominee Information:

Racial and ethnic identification (Please check all that apply)

Gender (If you prefer to self-describe, please choose "Other")

LGBTQ+ community

Upload Copy of Nominee’s Curriculum Vitae (no more than 4 pages PDF or DOC)

This field is required

Upload Letter of recommendation: Summary of relevant activities, indicating why you believe this individual should be selected as a participant in the ASGE Elevate Retreat (PDF or DOC)

This field is required

 

If you have questions contact:

Michelle Akers
Asst. Director of Practice Operations and Constituency Programs
dei@asge.org

Additional Opportunities

GOLD Program

The GOLD program enhances ASGE members' leadership and business skills for executive roles in gastroenterology.

Learn More
LEAD Program

The LEAD Program empowers female gastroenterologists through education, coaching, and networking.

Learn More