Application Form

REQUEST FORM FOR EDUCATIONAL GRANT OFFERED BY THE

5^th AISDD 2021

FOR REGISTRATION / ACCOMMODATION / TRAVEL EXPENSES

ELIGIBILITY

Please note that this opportunity is available to individuals who

• do not have sufficient funds available from a Healthcare Organisation or their own institution, that have been allocated to support travel and accommodation fees,
• have not received support from companies / industry,  
• are not already participating in a support programme for the 5^th AISDD 2021 and
• have not completed registration for the 5th AISDD 2021 before applying for the grant
• will be available to travel to the Symposium held on July 9 – 10, 2021

*The grants will primarily be given to participants travelling from abroad.

Completing the form below indicates your confirmation that the above statements are valid and you fulfil the eligibility criteria.

Your affiliation will have to be validated by an authorizing individual/ Department/ Institution/Local Medical Association/Gastroenterology Association. Uploading an officially signed document will be asked below to complete the application.

Personal Information