The British Pain Society - Patrick Wall Bursary Form

Home

About us

	Bursary application form British Pain Society Annual Scientific Meeting 2009 London, 31 March - 3 April 2009 Guidelines on how to submit your application can be found below this application form, or by clicking here Fields marked with a * are mandatory INCOMPLETE FORMS WILL NOT BE ACCEPTED FOR CONSIDERATION This form must be countersigned by your Head of Department.

	Section A: Personal Details
	Title*
	First name*
	Surname*
	Contact address
	Email*
	Institution name /place of work (if different from above)

	Section B: Checklist
	2009 membership subscription	I have paid my 2009 membership subscription to the British Pain Society.
	Evidence of good standing within the Society (i.e. length of membership/other contributions to work of the society )
	Current salary per annum before tax
	Travel costs
	Accommodation costs per night
	Number of nights
	Total amount applying for
	Other sources	I confirm that there is no other source of funds available to me to cover the expenses.
	Participant Registration Form	I confirm that I have returned the Participant Registration Form to the British Pain Society.

	Confirmation
	Applicant's Confirmation*	I confirm that all the information submitted on this form is correct and conforms to the guidelines set out below.
	Date*


	Confirmation by the Applicant’s Head of Department
	I confirm that the above name applicant is a member of this Department and that he/she does not have any other sources of funds to attend the Annual Scientific Meeting of the British Pain Society and that his/her annual salary is correctly stated above. If the applicant is not submitting a poster, please provide a justification for his/her need to attend the Meeting.
	Title (Mrs, Mr, Dr etc.)*
	First name*
	Surname*
	Position*
	Telephone*
	Email address*
	Supervisor's Confirmation*	I confirm that all the information submitted on this form is correct and conforms to the guidelines set out below.
	Date*



	GUIDELINES FOR APPLYING FOR AN ASM BURSARY DEADLINE: Friday 6th February 2009. This Bursary Application Form must be completed and returned to the British Pain Society Secretariat no later than Friday 6 February 2009. Who is eligible to apply for a bursary? In order to be eligible to apply for a bursary, the applicant must: Have a salary lower than £32,000/annum Have paid the 2009 British Pain Society subscription fee Evidence of good standing within the Society (e.g. length of membership of the Society, other contributions to the work of the Society). Priority will be given to those on lower salaries and those submitting a poster that is accepted for exhibition at the Meeting. How should the application be submitted? The applicant must complete and return this Bursary Application Form to the British Pain Society Secretariat no later than Friday 6 February 2009, together with the completed Participant Registration Form. The Bursary Application Form must be counter-signed by the Head of Department If the applicant is not submitting a poster abstract, the Head of Department must provide justification for the applicant’s need to attend the Meeting. The applicant must not send payment with the Bursary Application Form. What financial support is given? The level of support offered to each applicant is dependent on the number of applications submitted, the applicant’s salary and whether the applicant is exhibiting a poster at the Meeting. Applicants may request the following financial support: Registration fees to attend the Meeting Travel expenses Accommodation expenses up to a maximum of £50/night for 3 nights When will the applicant hear if the application is successful? Applicants will be informed of the outcome by 20th February 2009. When can the applicant expect to receive the financial support? If the application is successful, the Society will waive the registration fee and the applicant’s registration to attend the meeting will be processed with immediate effect. If the application for support towards the cost of accommodation and travel expenses is successful, the Society will reimburse the costs after the Meeting, once receipts are submitted. Receipts are to be sent to the Secretariat, marked for the attention of the Honorary Treasurer.

© The British Pain Society 2006-2007-2008 Disclaimer | Contact Us | Site map | Home

A company registered in England and Wales and limited by guarantee.Registered address: Third Floor, Churchill House, 35 Red Lion Square, London WC1R 4SG.
Registered No. 5021381. Registered Charity No. 1103260 Charity registered in Scotland No: SC039583