To apply online for the International Outreach Initiative, please complete and submit the form below.
Eligible applicants will be from low-or middle-income countries and must be affiliated with a hospital, university, clinic, or a cooperative group of institutions within an eligible region. ASH will not consider applications for personal or individual use.
Applicant Contact Information:
* = Required Field
* Facility Type:
Please provide a brief statement describing how the materials will be used and distributed at your institution.