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Application Deadline : To Be Announced

Personal Information

  • Please use your name as it appears on your Passport in filling out this application
  • Please be sure you have an email that is working, you are checking regularly, and is easily able to identify you (no nicknames or letters that can confuse the Application Reviewer as to who you are in your email address). If needed create a new email that identifies you by your name.

Application Process:

To be considered for this program, you must meet the following requirements: Which will include:

  • Hemophilia A & B all severities
  • Between the ages of 21 and 25 (no exceptions)
  • Access to factor for the duration of the conference.
  • No factor or infusion assistance will be provided for the duration of conference dates (no factor or infusion assistance can be provided during the program)
  • Proficient in written and spoken English (no exceptions)
  • Able to attend all program sessions
  • Able to travel unaccompanied and with appropriate visa and/or passport
  • Your treating medication to bring to the program meetings
  • Able to fulfill all aspects of the program criteria and understand what is being asked of you.
  • To be considered for this program, you MUST meet all the criteria listed above!

Before Applying:

You meet all the criteria listed. Include the following pieces of your application.

  • A letter of diagnosis from your medical team (physician or nurse) confirming your bleeding disorder diagnosis including severity.
  • A letter of support from your local foundation, chapter, or association. Acknowledging their support of you being in the SURO Program
  • A letter of support from a person who can attest to your leadership abilities and be able to meet the goals and responsibilities of a leadership program. This person can be a teacher or professor, employer, etc. It can not be a family member!
  • A personal essay describing your interest, qualifications, and reason why you should be selected to be in the Global SURO Program. A minimum of 500 words is expected.
  • Completion of the online application
  • An incomplete application will not be considered.
  • All Selected Applicants will have a virtual interview set up as the last part of being accepted into the Global SURO Program.

Can’t Complete the Application Online?

Unable to Complete the Application? We encourage applicants to fill out our online application. If you cannot fill out the online application, you may download a PDF of the SURO application here. Submit it with your supporting documentation listed above. Letter of Diagnosis and Personal Essay via:

    SECTION 1: PERSONAL INFORMATION

    SECTION 2: EMERGENCY CONTACTS

    SECTION 3: MEDICAL INFORMATION

    How long have you attended this treatment center?
    Do you have limited mobility or require any special services? *
    YesNo
    SECTION 4: TRAVEL INFORMATION

    Do you have a valid passport? *
    YesNo
    SECTION 5: ADDITIONAL INFORMATION REQUIRED TO PROCESS YOUR APPLICATION
    Before Applying:


    *At least one letter of reference from a teacher, care provider, employer or others able to recommend your participation.

    *One letter of support from your local foundation, association or chapter.
    SECTION 6: RELEASE OF INFORMATION/LIKENESS AND CONTACT INFORMATION

    I understand I must have factor concentrate available for me to bring to the SURO Program Meetings in the event of a bleed and/or emergency.
    I understand failure to bring factor concentrate or my treating medication with me to the SURO Program Meetings will be caused to be dismissed from the program.
    By submitting your application, you grant permission for any photographs or video taken of you during the Step Up Reach Out sessions and activities, and any that you may take related to program activities, to be used in publications or pamphlets for further promotion of the Global Blood Disorder Foundation Inc. and Global Blood Disorder Foundation Program Faculty. You are also aware of needing to have your factor concentrate or treating medication with you at the program meetings and the consequences if you do not.
    SECTION 7: DISCLAIMER OF ACCEPTANCE