Society of Laparoendoscopic Surgeons

  • Outstanding Minimally Invasive Surgery Resident Nominee:

    Please provide the following information about the nominated Resident:



  • Resident's Degree *
  • Select a Choice *
  • Program Director / Chairman

    Please provide the following information about the Chairman or Director who nominated Resident:



  • Director/Chairman's Degree *
  • - -
  • - -
  • / / Pick a date.
  • Name/Address of Person to whom we should send packet