Fellowship program director reference form for Junior membership applicants All fields are required Please enter the Sponsor's information: Please indicate the name of the person applying for membership: is applying for Junior membership status in the Society of NeuroInterventional Surgery and has listed you as a Neurointerventional Fellowship Program Director Reference. Junior Members in the Society of NeuroInterventional Surgery are required to: Be in training in an interventional neuroradiology, endovascular neurosurgery or interventional neurology program; Have a letter of reference from their Program Director. Neurointerventional fellowship program questionnaire: 1. How long have you known the applicant? 2. Is the applicant a current neurointerventional fellow under your direction? 3. Approximately how many neurointerventional procedures are performed per year at the institution(s) where the applicant was training? <5050-100100-150150-200>200 Do you feel that the applicant is: AcceptableUnacceptable as a Junior Member of SNIS?