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World Health Assembly and Youth Pre-World Health Assembly Unified Application Form for IFMSA Members

Dear IFMSA members, We are pleased to warmly invite you to apply for the IFMSA delegation to the 66th World Health Assembly, which will be held on May 20th-28th, 2013, and the Youth Pre-World Health Assembly (Pre-WHA), which will be held between May 16th-20th, 2013, both in Geneva, Switzerland. Application Requirements Be between 17 and 29 years old Regional representation and diversity, especially with emphasis on reaching global south Have previous knowledge and active experience in one or more of the following topics: international relations, global health, advocacy, leadership, public health Be proficient in English (both written and spoken) Be expected to attend and participate actively within the Pre-World Health Assembly and World Health Assembly Event May 16th-28th as well as the World Health Assembly on May 20th-28t. Be committed towards engaging actively in the follow-up process of the event, which includes, but not limited to, submitting in-depth reports and participating in followup surveys. Submit a complete application form by April 1st, 2013. Participation Fees Conference Participation Fee: 430 Euros. The participation fee is all-inclusive and covers the venue, programming, breakfast, lunch, dinner as well as housing during the Pre-World Health Assembly between May 16th-20th. On the other hand, WHA attendance is free, but selected IFMSA attendees are responsible for their own food, accommodation, local transport, and other expenses.
Please note, that the Organizing Committee does not provide accommodation for the World Health Assembly (May 20th 28th). Please write the organizing committee, should you need accommodation for the World Health Assembly (May 20th28th), as we might be able to assist you in finding housing for that time.

Application Deadline Please fill out this form and send it back to us via email by April 1st, 12.01pm GMT. Email Address: youth.pre.wha@gmail.com. For any further questions, please feel free to contact us anytime (youth.pre.wha@gmail.com and lwho@ifmsa.org). Yours Sincerely, The Organizing Committee of the Youth Pre-World Health Assembly and the IFMSA Liaison Officer to the WHO

General Information
Your Name: Email Address: Your Country: Your NMO: Date of Birth (DD/MM/YYYY): Gender (Male/Female): Passport Number: Passport Issuing Country: Issuing Country: Issue Date: Expiration Date: Will you be able to attend the Pre-World Health Assembly (May 16th-20th)? (Yes/No): Will you be able to attend the World Health Assembly (May 20th-28th)? (Yes/No): Will you require financial assistance to attend the meeting? (Yes/No):
Please note that travel funds are limited and will depend on the amount fundraised by the organizing committee.

Will you be able to attend the meeting in the case you should not receive financial aid from the Organizing Committee? (Yes/No):
The Organizing Committee in any case will be able to provide you assistance in fundraising for yourself by sending letters of support and template letters to address to your university, country office, etc.

Topic of Interest (You may tick more than one): ___ Health in the Post-2015 Development Agenda ___ Social Determinants of Health ___ Consultative Expert Working Group on Research and Development ___ Human Resources for Health ___ Sexual and Reproductive Health ___ Others (Please specify)

Motivation Letter
Please share your motivation to attend the Pre-World Health Assembly and/or the World Health Assembly (maximum 1 page). Explain your interest in the topic and events, as well as how you plan to use what you will learn from the events.

Plans for the Meeting


Please share your concrete plans for Pre-World Health Assembly and/or the World Health Assembly (maximum 1 page). Please be as specific as possible.

Curriculum Vitae
Please Provide a relevant Curriculum Vitae (maximum 2 pages):

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