The Pan-American Glaucoma Society Awards at the

XXX Pan-American Congress of Ophthalmology
& XXXVII Brazilian Congress of Ophthalmology

August 7-10, 2013

The Pan-American Glaucoma Society (PAGS) is offering three (3) awards in the amount of US$1,500 each for the three best glaucoma free papers accepted for presentation at the XXX Pan-American Congress of Ophthalmology in Rio de Janeiro, Brazil, August 7-10, 2013.Applicants for the PAGS Awards must have had an abstract with the accepted for presentation at the joint PAAO/Brazilian Congress with the technical/subspecialty area of Glaucoma

Abstract Submission deadline - March 1, 2013

Abstracts must be submitted to the joint PAAO/Brazilian Congress website: ( by March 1, 2013.

Please note that you MUST be registered for the Congress in order to access the Participant Area. Only glaucoma abstracts selected for presentation at the Congress are eligible to apply for the Pan-American Glaucoma Society Awards.

ManuscriptSubmission deadline - July 1, 2013

Submit all requested materials to Write "PAGS Award Submission" in the subject line.

Eligibility

  • Glaucoma abstracts accepted for presentation at the XXX Pan-American Congress of Ophthalmology and the XXXVII Brazilian Congress of Ophthalmology, August 7-10, 2013, Rio de Janeiro, Brazil.
  • The first author will be the representative of the paper if it wins an award.
  • An additional point will be added to the final score by the judges for first authors of 35 y/o or less at the time of July 1st.

Manuscript Submission Criteria

Papers to be submitted shall comply with all the following requisites:

  • Submission form duly filled out and signed (personal data, address, information about the paper).
  • Digital photo of the author (passport style, taken within the past year), in either 3x4 or 5x7 format.
  • Letter of acknowledgment issued by each co-author study stating that they authorize the first author to receive the award.
  • Statement declaring that the paper has not been published.
  • Copy of email/letter confirming acceptance of abstract for the joint PAAO/Brazilian Congress.
  • In preparing the manuscript, author should follow the guidelines of the American Journal of Ophthalmology for submitting papers (
  • Text, containing: title, authors, introduction, methods, results, discussion/comments, conclusions and references (*). English only.
    (*) standard size complying with the standard defined by the organizing committee (8.5x11, 1 inch margins, double spaced).
  • Submit all requested materials to "PAGS Award Submission" in the subject line

Pan-American Ophthalmological Foundation

2013Pan-American Glaucoma Society (PAGS) Award

Application Form

Manuscript Receipt Deadline: July 1, 2013

Type all Information

PAAO ID: (please contact PAAO Office if you don’t know your membership ID number)

Name of Applicant/Main Author:

First Name, Middle Initial, Last Name (s)

Degree(s)

MD, PhD

Mailing Address:

City: State/Providence:

Country: Zip:

Office Phone: () Fax Number: ()

Home Phone: () Birth Date: / /

mmddyyyy

Email: Citizenship:

Title of abstract accepted for presentation at the joint PAAO/Brazil Congress:

Abstract (same as what was uploaded to the Congress site)

APPLICATION MATERIALS:

  1. Application form (this form), duly filled out and signed (personal data and address information for the main author).
  2. Digital photo of the main author (taken within the last year), in either 3x4 or 5x7 format (jpg, gif or tif).
  3. Letter of acknowledgment issued by each co-author study stating that they authorize the first author to receive the award.
  4. Statement declaring that the paper has not been published.
  5. Copy of email/letter confirming acceptance of abstract for the joint PAAO/Brazilian Congress.
  6. In preparing the manuscript, author should follow the guidelines of the American Journal of Ophthalmology for submitting papers.
  7. Text, containing: title, authors, introduction, methods, results, discussion/comments, conclusions and references (*). English only.

(*) standard size complying with the standard defined by the organizing committee (8.5x11, 1 inch margins, double spaced).

APPLICANT AGREEMENT

I have read and accepted the above terms and responsibilities for the 2013 Pan-American Glaucoma Society (PAGS) Award.

(A) I understand that noncompliance will be grounds for termination of the award.

(B) I assume entire responsibility and hereby agree to protect, indemnify, defend, and save the Pan-American Ophthalmological Foundation (PAOF) and the Pan-American Association of Ophthalmology (PAAO) and their employees and agents, harmless against all claims, losses and damages to persons or property, governmental charges, or fines and attorney’s fees arising out of or caused by my participation in the 2013 Pan-American Glaucoma Society (PAGS) Award program.

Applicant’s Signature: Date

Disclaimer: Employees of the Pan-American Association of Ophthalmology (PAAO), Pan-American Ophthalmological Foundation (PAOF), members of the PAAO Executive Committee, members of the PAOF Board of Directors, their immediate family members and members of the same household, whether related or not, are not eligible to apply for scholarship/fellowship funding. All scholarships are subject to federal laws and regulations and are void where prohibited by law or regulation. Applicants agree to abide by the terms of these official rules and by decisions of the Review Committee which are final and binding on all matters pertaining to the scholarship/fellowship. The PAAO & PAOF reserve the right to disqualify any applicant that they determine, in their sole discretion, to be ineligible to participate in the scholarship/fellowship program. Individuals who have previously received scholarship/fellowship funding are ineligible to apply for additional scholarships/fellowships/funding.

PLEASE RETURN PAGES 2 and 3 plus all requested material to .

Page 1