APPLICATION FORM

Deadline for Submission 28 FEBRUARY 2017

Applications are submitted by the ICGEB to the relevant Liaison Officer, and are not considered for review unless endorsed: ensure you have your complete Endorsement Form ready for upload to the relevant section of this application form

ENDORSEMENT FORM:
- Download and open the attached form with Adobe Acrobat Reader tl_files/Meetings/2015/get_adobe_reader.png
- Complete the form with data, signatures and stamp for the Scientific Organiser and Organising Institution and save it

 

ICGEB support requested for



 

Meeting details



Type of ICGEB Course/Meeting*



Indicate city and country where the meeting will be held (City, Country)


Indicate first and last day of the meeting (dd/mm/yyyy - dd/mm/yyyy)


Indicate effective number of days on which scientific sessions will be held

 

Organising Institute

(in charge of the meeting organisation and ICGEB grant management)


 


Specify full name and address of the organising INSTITUTE




Indicate name and surname of the legal officer who will be in charge of signing and executing the ICGEB agreement




Indicate name, surname and e-mail address of the person responsible for financial management of the ICGEB agreement



Indicate name, surname and e-mail address of the administrative person who will be included in all e-mail correspondence related to the project

 

Scientific Organiser


 









Upload CV in Microsoft Word or PDF file format. Ensure the file name includes the relevant extension ".doc", ".docx" or ".pdf"

 

Co-organisers

(if applicable)


 


Include name, full business address, telephone, fax, e-mail and eventual collaborations in scientific projects

 

Invited speakers


 


Include name, full business address, telephone, fax and e-mail

Indicate: number of lectures/teaching hours; whether 'contacted' or 'accepted'


If a practical component is anticipated, provide details of local teaching staff (name, full business address, telephone, fax and e-mail)

 

Subject areas


 



Indicate if the programme will include laboratory practical session(s) which foresee the use of animals*


 

Selection of participants


 




Specify if you expect to charge a registration fee to non-supported participants and, if so, how much and which costs it covers
Scientists from ICGEB Member States receiving support are to be waived registration fee


Specify if they will need to undergo a selection process or not

 

Venue


 



Specify if there are plans and technical resources available to share selected talks/sessions and/or meeting contents independently or through the ICGEB channels (podcast programme and social networks)
All video material must include ICGEB logo and mention ICGEB support



 

Budget


 


Specify the total amount you foresee will be needed to organise this meeting


Specify the amount you are requesting from ICGEB


Refer to the Terms of Reference for ICGEB Meetings for eligible costs

 

Other sponsors


 


Specify name of sponsor, sponsorship status (applied, awarded...), amount, what it will cover, requirements of the sponsor in case of award etc.
Include and detail contribution by organising institution, either direct or in-kind

PLEASE REFER TO THE Terms of Reference for ICGEB Meetings DETAILING ICGEB SPONSORSHIP REGULATIONS


Specify the amount you are expecting from Co-sponsors (indicate if requested/awarded)


 


Specify the amount you are expecting from other sources (indicate if requested/awarded)


Specify (international staff, participants, secretarial assistance, management costs, rent of laboratory and/or auditorium facilities, expendables - refer to instructions for details)


 

Your proposal may also be submitted to other sponsoring agencies/intitutions collaborating with the ICGEB. Do you authorise the ICGEB to proceed?*

 

ICGEB Liaison Officer Official Endorsement request


All ICGEB sponsored activities require an official endorsement by the ICGEB Liaison Officer of the Member State where the specific event takes place


(*) Image or PDF file format. Ensure the file name includes the relevant extension ".gif", ".jpg", ".jpeg", ".png" or ".pdf"

Applications are submitted by the ICGEB to the relevant Liaison Officer, and are not considered for review unless endorsed

 

Submit your application


By applying to the ICGEB annual call for meeting proposals, the submitting Organising Institution and Scientific Organiser hereby accept the ICGEB Terms of Reference governing the ICGEB Meetings and Courses programme

 

Once you have successfully completed and submitted your application, you will see a confirmation message on this screen.

Should this message not be visible PLEASE NOTE that your application has not been submitted. Check the mandatory fields to ensure information has been correctly inserted.

Upon receipt of your application, you will receive an e-mail confirmation from the ICGEB Conferences Unit, which will then submit your complete application to the ICGEB Liaison Officer in your country for evaluation and endorsement.

Cod. Fisc. 90031700322

AREA Science Park
Padriciano 99
34149 Trieste, ITALY
Tel: +39-040-37571
Fax: +39-040-226555
icgebicgeb.org
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