Apply for a Scholarship

Scholarship Application Form

Individuals wishing to apply for a Scholarship may submit an application by completing the information below and pressing the ‘submit’ button.

You should aim to complete the application by the end of July to give sufficient time for review prior to the meeting of the Scholarship Committee in the Fall.

You should ask a sponsor to complete the second part of the application as set out below and submit it to the Academy within a week of your application.

Note 1: Before applying, the applicant must contact the institution where he/she intends to pursue his/her studies and find out if an English test is required. If so, the test must be taken and passed before applying for the Scholarship.

Note 2: Scholarships are not granted for training that has already been undertaken; all proposed training should commence after 1^st January of the year following the application.

For further information, please contact the Chair of the Scholarship Committee by email: scholarship@iaasm.org.

PART I – TO BE COMPLETED BY APPLICANT

The fields marked with (*) are required.

Full name(*)

This field is required.

Phone number(*)

This field is required.

Title(*)

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E-mail(*)

Invalid email address.

Country of birth / Nationality(*)

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Date of birth(*)

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Home address

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Work address

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Education ( institution attended, time period )(*)

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Career activities since graduation ( organization, activity, time period )(*)

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Publications(*)

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Honours and awards received (*)

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Military service(*)

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Future career plans(*)

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SCHOLARSHIP REQUEST:

A. Purpose (*)

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B. Finance requested (*)

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C. Other sources of financial support (*)

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State in detail why you consider that you should receive financial support from the academy (*)

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If I am selected as the successful candidate and receive the Scholarship, I will make every effort to keep in contact with the Academy and agree to notify the Chairman of the Scholarship Committee and the Secretary General of my career progress by sending an update to them at least once per year.(*)

I agree

Please check this box if you agree

Scholarship Application Form

PART II - TO BE COMPLETED BY SPONSOR

The Sponsor should be a physician who has experience in aviation/space medicine and who has knowledge of the applicant, including his/her professional interests.

The fields marked with (*) are required.

Full name(*)

This field is required.

Phone number(*)

This field is required.

Title(*)

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Present position (*)

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E-mail(*)

Invalid email address.

Correspondence address

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Are you a member of IAASM - The International Academy Of Aviation And Space Medicine? (*)

YesNo

Please check the right answer.

Applicant full name(*)

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Relationship with and time for which you have known the applicant (*)

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Recommendation (*)

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Scholarship Application Form

Scholarship Application Form

International Academy of Aviation and Space Medicine

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