ESSO INTERNATIONAL TRAINING FELLOWSHIPS
The European Society of Surgical Oncology (NPA)
Avenue E. Mounier, 83 | B-1200 Brussels | Belgium +32 2 537 31 06 +32 2 539 03 74 fax www.essoweb.org
Curriculum Vitae Application Form Title
First Name
Last Name
Birthdate
Nationality
Membership ID number
Tel
E-mail
Address
Name
Personal data
Major Award (10.000 EUR)
Which fellowship are you applying for?
Institute you wish to visit
Degree subject/ Professional Qualification (s)/ Institution where awarded. Present and Previous Positions Held (include dates to and from) Relevant Publications (Maximum 10)
Presentations to learned societies (maximum 10)
Standard Fellowship (2.000 EUR)
I am interested in the Standard Fellowship if my application is not accepted for the major fellowship Name
Department
Contact Person
E-mail
The European Society of Surgical Oncology (NPA)
Avenue E. Mounier, 83 | B-1200 Brussels | Belgium +32 2 537 31 06 +32 2 539 03 74 fax www.essoweb.org
Research Grants on which the applicant was listed as a coapplicant (date, co-applicant, title, amount and funding body). (Maximum of 10)
Supporting documents
Motivation letter describing area of interest, Supporting letter from own Head of research plan and reason behind the visit. Department The motivation letter should outline what the applicant expects to achieve during his/her visit. It should therefore detail what specific experience is sought and how this would fit into the applicant’s individual career development. In particular, details should be supplied regarding the Institution to be visited as well as the clinical/research opportunities the hosting department can offer. Invitation letter from the Head of the Department you wish to visit indicating that the hosting unit is willing and able to provide the expected training experience AND confirming that the post will not be salaried.
A proposed budget sheet estimating how the funds will be spent (estimated cost of flights, accommodation, living expenses etc)
Date
Signature
Please send back your application form duly completed and all supporting documents in a single PDF document to the ESSO Secretariat, attention of Ana Galan, by fax (+32 2 539 03 74) or via e-mail ([email protected]) before the deadline of 31st October 2016.
Avenue E. Mounier, 83 | B-1200 Brussels | Belgium +32 2 537 31 06 +32 2 539 03 74 fax www.essoweb.org
Curriculum Vitae Application Form Title
First Name
Last Name
Birthdate
Nationality
Membership ID number
Tel
Address
Name
Personal data
Major Award (10.000 EUR)
Which fellowship are you applying for?
Institute you wish to visit
Degree subject/ Professional Qualification (s)/ Institution where awarded. Present and Previous Positions Held (include dates to and from) Relevant Publications (Maximum 10)
Presentations to learned societies (maximum 10)
Standard Fellowship (2.000 EUR)
I am interested in the Standard Fellowship if my application is not accepted for the major fellowship Name
Department
Contact Person
The European Society of Surgical Oncology (NPA)
Avenue E. Mounier, 83 | B-1200 Brussels | Belgium +32 2 537 31 06 +32 2 539 03 74 fax www.essoweb.org
Research Grants on which the applicant was listed as a coapplicant (date, co-applicant, title, amount and funding body). (Maximum of 10)
Supporting documents
Motivation letter describing area of interest, Supporting letter from own Head of research plan and reason behind the visit. Department The motivation letter should outline what the applicant expects to achieve during his/her visit. It should therefore detail what specific experience is sought and how this would fit into the applicant’s individual career development. In particular, details should be supplied regarding the Institution to be visited as well as the clinical/research opportunities the hosting department can offer. Invitation letter from the Head of the Department you wish to visit indicating that the hosting unit is willing and able to provide the expected training experience AND confirming that the post will not be salaried.
A proposed budget sheet estimating how the funds will be spent (estimated cost of flights, accommodation, living expenses etc)
Date
Signature
Please send back your application form duly completed and all supporting documents in a single PDF document to the ESSO Secretariat, attention of Ana Galan, by fax (+32 2 539 03 74) or via e-mail ([email protected]) before the deadline of 31st October 2016.
