BURSARY APPLICATION FORM
Please complete this form and return by email to firstname.lastname@example.org
Use more space than is provided if you need to.
1. Personal details
Title, first name and last name
2. Academic and professional qualifications with dates
3. Date of this application
5. Travel dates
6. Titles and authors of accepted posters or oral presentations
7. Eligibility to apply (confirm your eligibility by ticking the boxes as they apply to you)
a. I’m a resident of a country that is identified as an ‘emerging or developing economy’ by the
International Monitary Fund in it’s World Economic Outlook Database:
http://www.imf.org/external/pubs/ft/weo/2010/01/weodata/groups.htm#oem, or ;
b. I’m a resident of a Central or Eastern European country as listed in the World Economic Outlook
c. I’m a resident of North Korea or Cuba
d. I’m a young professional not older than 35 years of age
e. I’m a PhD student
Supervisor or Line Manager
Field of study/employment
Title of research project, training programme
(students) or job title (lecturers and other staff)
Start date of training programme or current
Responsibilities. Summarize your main responsibilities in your current post, in particular those that are relevant to
8. List your most recent publications (up to 5). Papers in press, posters and presentations can be included.
9. Give the name and full contact details of one referee other than your current supervisor/line manager.
We may contact your named referee and/or your current supervisor/line manager for a reference.
A bursary will cover the cost of the conference registration fee (including meals and social events as appropriate)
and 5 nights’ accommodation including breakfast (accommodation allocated by the Organizing Committee). All
other expenses, including travel, are the responsibility of the delegate and will not be reimbursed. Applications
are judged by the ISVEEXIII Organizing Committee, based on a set of eligibility criteria and bursaries will be
awarded on a competitive basis.
Have you applied, or do you intend to apply, to any other funding sources for this conference?
If yes, to whom and for how much? Please state when you expect to know the outcome of the application(s).
11. Justification for a bursary award
Explain what the potential outcome(s) of the trip will be and how your attendance at the conference will
benefit you and others.
I declare that the details on this form are correct to the best of my knowledge. If I am awarded a
bursary, I will use it under terms and conditions attached to it by ISVEEXIII (see below) and only for the
purposes stated in this application form. In making this application, I am consenting to ISVEEXIII holding
my personal details and understand that they will only be used for the purpose of evaluating this
application. I accept that ISVEEXIII may disclose this application form to any third parties that it
considers necessary to reach a decision on the application. If I am awarded funds for this trip by any
other party, I will inform ISVEEXIII within two weeks of offer or receipt of these funds and accept that
the contribution offered by ISVEEXIII may be modified accordingly, or withdrawn altogether.
ISVEEXIII BURSARY AWARD TERMS AND CONDITIONS
Bursary awards are offered under the following terms and conditions:
1. That the applicant has an accepted presentation on the conference (either poster or oral)
2. That the trip is undertaken as outlined in the application, and for the purpose of attending the ISVEE
XIII conference only.
3. The bursary is a personal award made to the named applicant and cannot be transferred to another
person or to an institution/organization.