Society for the Study of Sexually Transmitted Diseases in Ireland

Sponsorship

Application for sponsorship to attend course / conference

You must be a current member of the Society to apply for sponsorship (If you wish to apply for membership, please go to the membership page)

* All fields are required

Describe the course/conference

Give date, time, location and duration, as well as the objectives, content etc. *:
Who is the course/ conference aimed at? *:

Personal and Professional Details

Name and Surname *:
Academic Title(s) *:
Current position *:
Hospital/ Institute/ practice *:
Address *:
Email Address *:
Telephone *:
Mobile *:

Professional Experience

Years of experience in field *:

Motivation

Please provide us with your motivation to participate in the course/ conference and your expectations of how you will apply the new skills in your daily work *:

Sponsorship requested

Total Amount *:
(please don't enter the euro symbol)

(Please itemise expenses below)

Travel (economy class) *:
(please don't enter the euro symbol)
For accommodation *:
(please don't enter the euro symbol)
For registration *:
(please don't enter the euro symbol)
 
Society for the Study of Sexually Transitted Diseases in Ireland