TCRN Conference & Professional Development Grants 2017 Round 2 Application Form Applications close 5pm, 15 May 2017 For travel between 1 July 2017 -31 December 2017 Please read the TCRN Conference & Professional Development Grants 2017 for Round 2 Guidelines while completing this application form. Note: No late applications will be accepted Please complete ALL relevant sections of this application and ensure that all information is correct and complete. Proof of invitation to speak or acceptance of abstract is necessary. Incomplete or incorrect applications WILL NOT be considered. Please note that any travels that have already commenced or completed before submitting the application will not be considered. I am applying for (select one): Conference Grant Professional Development Grant Section 1: Applicant Details First name Surname Mobile Email The University of New South Wales Border Medical Oncology Research Unit University of Technology, Sydney Prince of Wales Hospital Employer Calvary Health Care St George Hospital/Sutherland Hospital Australian Institute of Health Innovation The Royal Hospital for Women Other (list): Administrator Senior Researcher Allied health professional (list): PhD student Clinician Researcher – PhD supervisor name: Clinician nurse – Profession Consumer Junior medical staff (only if you are not eligible for Health Services Manager TESL leave) Research Assistant Other (list): Post-doc Fellow Broad Basic Science Health Services Research Research Clinical Medicine and Science Public Health Area Preventive Medicine N/A T2 Translational All T1 T2/T3 Pipeline N/A T1/T2 T3
TCRN Conference & Professional Development Grants 2017 Round 2 Application Form Applications close 5pm, 15 May 2017 For travel between 1 July 2017 -31 December 2017 Please read the TCRN Conference & Professional Development Grants 2017 for Round 2 Guidelines while completing this application form. Note: No late applications will be accepted Please complete ALL relevant sections of this application and ensure that all information is correct and complete. Proof of invitation to speak or acceptance of abstract is necessary. Incomplete or incorrect applications WILL NOT be considered. Please note that any travels that have already commenced or completed before submitting the application will not be considered. I am applying for (select one): Conference Grant Professional Development Grant Section 1: Applicant Details First name Surname Mobile Email Employer Border Medical Oncology Research Unit Prince of Wales Hospital St George Hospital/Sutherland Hospital The Royal Hospital for Women The University of New South Wales University of Technology, Sydney Calvary Health Care Australian Institute of Health Innovation Other (list): Profession Administrator Allied health professional (list): Clinician – Researcher Clinician – nurse Consumer Health Services Manager Research Assistant Post-doc Fellow Senior Researcher PhD student PhD supervisor name: Junior medical staff (only if you are not eligible for TESL leave) Other (list): Broad Research Area Basic Science Clinical Medicine and Science Preventive Medicine Health Services Research Public Health N/A Translational Pipeline All N/A T1 T1/T2 T2 T2/T3 T3
Application%20Form_TCRN%20Conference%20%26%20PD%20Grants_Round%202%202017_0.docx