The Association for Surgical Education

Impacting Surgical Education Globally

Applications must be formatted in Arial or Times New Roman font of at least 11 font size, single-spaced, and at least half-inch margins (top, bottom, left, and right) for all pages. Applications should include the following items, which should be assembled into a single PDF document. Brief essays should not exceed 3 paragraphs/ one page.

  1. Cover Page:  See details below. 
  2. Brief Essay 1: How will you use this award to advance your career as a surgical educator?
  3. Brief Essay 2: How do you anticipate that this award will foster your engagement as an ASE member?
  4. Current CV and Education Portfolio
  5. A summary document of all activities and presentations for the Association for Surgical Education, including ASE meetings attended
  6. Letter of support from Department Chair, Division Chief, or Vice Chair of Education

Your Cover Page must include the following information. 

  1. Name
  2. Address
  3. Hospital and/or university affiliation:
  4. Ase Member: Yes? No?
  5. Phone Number
  6. E-mail Address
  7. What program/ course of study do you plan to pursue with this funding?
  8. Have you been accepted to the program or course of study? Yes? No?
  9. What is the approximate cost for the program or course of study?
  10. Do you have resources committed from elsewhere that will cover the balance of funding beyond the DaRosa Scholarship? Yes? No?

Accepted file types: pdf, Max. file size: 512 MB.
Applications must be formatted in Arial or Times New Roman font of at least 11 font size, single-spaced, and at least half-inch margins (top, bottom, left, and right) for all pages.