Train the Trainer Application - Cure Glaucoma Foundation

Program Overview

Train the Trainer
Glaucoma Drainage Device (GDD) Training Program

Cure Glaucoma Foundation has established a “Train the Trainer” Program (TTP). This initiative is designed to teach the latest glaucoma related treatments and/or surgical skills to doctors in developing countries.

Who Can Apply

Physicians in developing countries who provide local glaucoma treatment services or who are affiliated with a residency program, teaching facility, an established eye or community hospital.

Instructions

Please complete the Train the Trainer Program Application below or download the application.
you will also need the following documents to submit as part of the application process:

Scanned copy of Specialist Exam Certificate, Diploma of National Board, Master of Surgery, or equivalent
Letter of Recommendation
Three Professional References
Personal Statement

All completed applications received by midnight on the submission deadline will be accepted and reviewed
Applicants will be notified when the funding decision in made

Contact Information

^* required fields

First Name*

Last Name*

Professional Title and Position

Organization Affiliation*

Organization Affiliation Address

Phone (include country code)*

Home Phone*

Office Phone*

Cell Phone*

Fax Number*

E-Mail*

Language(s): Reading, Speaking, Writing (and Excellent, Good, Fair or Poor)

Education

Describe your Education and any Honors

Ophthalmology Related Volunteer Work

Please describe any ophthamology related volunteer work including the institution and dates of service.*

Train the Trainer Event Description

Please provide a description for an event that would best serve the needs of your organization.

What is the name and location of the organization that will host this event?

What is the number of trainees you are expecting?

Will there be access to a Wet Lab Facility? (Please provide details)

Will there be a possibility for live surgery training? (Please provide details)

Do you have any funding to support this event? (If yes, please explain)

Goals

Describe what knowledge and skills you wish to acquire.

What do you want to be able to do with what you learn?
What are the practical implications of this fellowship on your professional development?

How will you enhance eye care and education in your country?*

Application Support Documents

Scanned Copy of Certificate, Diploma, or equivalent*

Letter of Recommendation*

Professional References (3)*

Personal Statement

“Train The Trainer” Program Contact

For enquiries about the Train The Trainer Program please call, write, call or email program contact, Mike Kettles.

Mike Kettles

mkettles@cureglaucoma.org

(+1) 214-765-9716

Cure Glaucoma Foundation
Attn: International Fellows Program
10740 N. Central Expressway, Suite 300, Dallas, TX 75231