Application portal for Rosalie Shaw Travel Scholarship and APHN Bursaries

Note:

  • Applications will be processed through this centralized portal. The selection committee of APHN will shortlist one awardee for the scholarship and 20 awardees for the bursaries. All applicants will be considered for BOTH the Rosalie Shaw Travel Scholarship (RSTS) and APHN bursary.
  • You will receive a copy of your application in your email once you have submitted the form successfully.

Rosalie Shaw Traveling Scholarship and APHN Bursaries Application Form 2019

Name of Applicant: *
E-mail: *
APHN Membership ID:
Title: *
Gender: *
Profession: *
Specialty: *
Current Position / Title: *
Institution / Organization: *
Country: *
No. of years working in palliative care: *
Proportion of your current working time devoted to palliative care: *
Please indicate if you will be presenting a poster or oral presentation: *
If yes, please indicate title:
List the objectives and outcomes you want to achieve by participating in this conference: *
Name of 1st Supporter: *
1st Supporter's Email: *
Name of 2nd Supporter: *
2nd Supporter's Email: *
If you have received or expect to receive funding from other sources, please specify donor and amount: :
I declare that the information I have given in this application is true and correct.:
Upload your CV: *
Upload any other supporting documents if any: (e.g. references)