Submission Form

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Current Residency Program

Current Year in Residency- Note: You must be an incoming PGY-3 or PGY-4 as of July 2025 to attend Eyeprentice

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Tell us why you would like to attend the fellowship showcase

What is your vision for the next chapter of your journey in the field of ophthalmology?

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Terms & Conditions

TERMS & CONDITIONS

Please read these Terms and Conditions carefully before applying for the Eyeprentice 2025 Cataract, Refractive, and Anterior Segment Fellowship Showcase. By submitting an application, you agree to the following terms:

Application and Selection
Submission of an application does not guarantee selection for the Eyeprentice 2025 Cataract, Refractive, and Anterior Segment Fellowship Showcase. Applications will be reviewed by the selection committee, and only chosen candidates will be notified.

Travel and Accommodation Coverage
Eyeprentice may assist with certain travel expenses for selected fellows attending the Eyeprentice 2025 Showcase. Any other expenses, including but not limited to meals, transportation, additional nights of accommodation, and personal expenses, are the sole responsibility of the participant.

Program Approval Requirement
Applicants are responsible for obtaining any necessary approvals from their residency program prior to attending the Eyeprentice 2025 Showcase. Eyeprentice will not be responsible for any consequences or actions taken by a program as a result of a participant’s attendance.

Attendance Requirements
Selected residents must attend all designated sessions and activities scheduled as part of the Eyeprentice 2025 Showcase. Full participation is expected to gain the intended benefits and fulfill the requirements of the fellowship application process.

Liability Waiver
Eyeprentice is not liable for any personal injury, loss, or damage incurred by participants during travel or attendance at the Eyeprentice 2025 Showcase. Participation in the showcase is at the individual’s own risk.

Code of Conduct
All participants are expected to maintain a high standard of professionalism and respect throughout the event. Eyeprentice reserves the right to remove any participant found violating this code, with no obligation to reimburse costs incurred.

Acceptance of Terms
By submitting an application, you acknowledge and agree to these terms and conditions. Failure to adhere to any of the above terms may result in forfeiture of benefits and participation privileges.

I, the undersigned, agree to the terms above.

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PGY-3 and PGY-4 Resident Application

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