Mary Jane O'Neill Fellowship Application

The 2024 Mary Jane O’Neill Fellowship will bring an individual to the United States for a 2 week period during June 2024 to intern at an EBAA member host eye bank and attend the EBAA Annual Meeting, June 5-8, 2024, in Kansas City, Missouri. Once a Fellow is selected, the EBAA will work with the eye bank and the Fellow to determine the actual dates of the program.

To apply for the 2024 Mary O’Neill Fellowship, please complete the form below and upload the following documents:

Current Curriculum Vitae
Letter of support from your organization (your eye bank, university center, hospital, or medical society)
Letter verifying that the applicant is representing an eye bank
Two letters of recommendation

NOTE: You must be able to speak and understand English fluently.

Deadline to Apply: August 11, 2023.

Contact Genevieve Magnuson with any questions regarding the Fellowship.

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Applicant Information

Please enter your personal information below.

Name*

Applicant Name

First Last Designation

Email:*

Cell Phone Number:

Job Title/Role at Eye Bank:*

Years in Eye Banking:*

Do you manage staff? If so, how many?

Organization Information

Please enter your work information below.

Organization/Eye Bank:*

Work Phone Number:

Year that your eye bank was founded.

Number of staff employed at your eye bank.

Eye Bank Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Eye Banking Background Information

List any previous organized training in eye banking that you and your staff members have received:*

List any regional or national eye banking organizations of which your eye bank is a member:*

Briefly describe your duties and responsibilities at the eye bank (Limit 250 words):*

Briefly describe the process of how you or your bank obtains, evaluates, and distributes tissue for transplantation (Limit 250 words):*

List and describe any regulations your government has which relate to eye banking:*

How many corneas did your eye bank recover in the past year?

Goals of Fellowship

What specific aspects of eye banking are you interested in learning more about during the Fellowship? (Please include any goals you have for the fellowship and/or any skills you wish to learn or improve during the fellowship. Limit 300 words):*

Briefly explain how this Fellowship program will benefit you as a professional in the area of eye banking, the eye bank that you represent, and the impact that this Fellowship might have on eye banking in your country. (Limit 300 words):*

Acknowledgement of Terms

Acknowledgement of Terms. I agree to the following: (Please check each box).

Untitled*

I have permission from my eye bank to apply for this Fellowship.

Untitled*

I am employed by or affiliated with an eye bank, which is operational and active.

Untitled*

I am a Manager, Executive Director, Medical Director or Experienced Technician/Supervisor employed by an eye bank with decision-making responsibility.

Untitled*

I can speak, read, and write English fluently.

File Upload – Resume/CV

Please upload your Resume/CV here.

File*

Drop files here or

Accepted file types: word, jpg, pdf, doc, docx, , Max. file size: 25 MB.

File Upload – Letters of Support and Verification

Please upload your letters of support and verification from organization here.

File*

Drop files here or

Accepted file types: word, jpg, pdf, doc, docx, , Max. file size: 25 MB.

File Upload – Letters of Recommendations

Please upload your letters of recommendation here.

File*

Drop files here or

Accepted file types: word, jpg, pdf, doc, docx, , Max. file size: 25 MB.

File Upload – Photo Upload

Please upload your professional headshot.

File*

Drop files here or

Accepted file types: word, jpg, pdf, doc, docx, png, gif, Max. file size: 25 MB.

Please check this box if all of the information in this application is correct and complete.*

Please check this box if all of the information in this application is correct and complete.

All information is correct and the application is complete.

Applicant Information

Organization Information

Eye Banking Background Information

Goals of Fellowship

Acknowledgement of Terms

File Upload – Resume/CV

File Upload – Letters of Support and Verification

File Upload – Letters of Recommendations

File Upload – Photo Upload

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