Any program leader or hospital administrator (other than the ICOS member endorsement), such as the Chief of Cardiology, Chief of Oncology, or President of Hospital can provide a letter of endorsement.
yes, central hub can apply and can include committees, publications, etc from affiliated sites
yes, you can reapply in the next year with no additional fee
you must re-apply in 3 years with repeat application fee, but abbreviated/updated application
You can pay by Paypal, credit card or check
one is being created and should be available for cycle two of applications