Deadline for submission of this form is 1 May 2006
Please note that to be eligible for any level of support to attend the conference the applicant must either be from a developing country, or be a student. All applicants must be offering either a paper or poster for presentation at the Conference. Strong consideration will be given to applicants who have identified partial support from their own institution or another agency. This application will be considered by a Committee. Recipients of funding will be notified before 15 May 2006. Successful candidates will be reimbursed at the conference on the supply of receipts (therefore, your institution will need to cover your costs on the basis that they will be reimbursed after the conference).
Please type your responses in the following boxes using your word processing package (eg Microsoft Word) and email the form along with any accompanying material to Mrs Pham Thi Hong Hanh (email: nipp-khkh@hn.vnn.vn, or Fax +84 4 8363 563) and to Dr Peter Brown (email: Peter.Brown@csiro.au, or Fax +61 2 6242 1505).
Personal Information
Information about spoken paper or posters
Paper 1 |
I will be, or have, submitted a paper / poster (please delete as required) |
Title : |
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Session : |
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Paper 2 |
I will be, or have, submitted a paper / poster (please delete as required) |
Title : |
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Session : |
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Justification of request for funding support
Please describe why you believe you should be supported to attend the conference. What will be your contribution? How will you benefit? How will your organisation benefit if you attend the conference? (Append additional page as needed.)
Curriculum Vitae or background information
Please provide a short CV or equivalent information (1 page) to assist the committee in consideration of the funding request.
Amount requested from the ICRBM Committee
Please provide breakdown of costs requested (eg airfares; accommodation; registration fee). Please add quotes from your travel agency.
Amount of support obtained from own institution or other agencies
Please provide breakdown of costs obtained in support.
Supporting statement from own organisation
Please attach separately a letter of support from your organisation. Include:
1. Signature of Head of Department and
2. Their email address.
3. A statement such as: ˇ°We understand that any award will be made retrospectively and will ensure that funds are made available to for the purchase flight tickets and visas....ˇ±
You can scan this information and send by email or send by fax.
For student applicants
Student applicants must provide the following information
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