EDUCATIONAL GRANT APPLICATION FORM
   
Title
First Name / Last Name *
Age *
Institution *
Address
City *
Province or State
Postal or Zip Code
Country *
Telephone
(Including country code)		 *
E-mail * *
 
I am applying for Educational Grant Support to cover my :

 
Hotel Reservation
Check in Date *
Check Out Date *

Your hotel reservation will be made regarding your flight ticket details by the Organizing Secretariat at the conference venue or any nearby hotel on room only basis.
You can contact the organization secretariat(registration@icurestroke.org ) for your additional night request.
Please note that;

  • Max. 3 nights will be covered and extra nights should be paid by attendee. You may contact Organizing Secretariat regarding extra night requirements.
  • Double supplement of accompanying persons will be covered by the attendees.
Upload File(s) :

Please upload your Short CV and Endorsement Letter (Letter from program director/supervisor endorsing the Educational grant request and authorizing the time off to attend the conference) by clicking the "Upload button".