AUA2020 - Speed Mentoring Program – Resident/Fellow (Mentee) Registration

AUA Member *

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International Resident/Fellow *

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AUA ID (If AUA Member)

First Name *

Middle Name

Last Name *

Name Suffix (Jr., III, etc.)

Credentials (MD, PhD, etc.) *

Email Address *

Country

AUA Section

Residency Program *

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Post Graduate Year *

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Fellowship/Specialty

End Date (MM/YYYY)

Gender

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Speed Mentoring Program – Resident/Fellow (Mentee) Registration