Clinical Forum D u b l i n 2 01 3

89 October 2013 | The Convention Centre Dublin, Ireland Pre-conference Workshops 7 October 2013 | 14:00 17:30

7th Annual

The DIA Annual Clinical Forum

This two day multi-track conference comprises five parallel themes addressing current challenges and hot topics in clinical research and medicines development. It brings together professionals from the biopharmaceutical industry, contract service organisations, academic research centres, public health authorities and patient organisations, and affords attendees the opportunity to network with delegates from all over Europe and worldwide.

DIA Europe Fellowship Programme

DIA Europe promotes the participation of patients, students and young professionals in the 7th Annual Clinical Forum by offering up to 25 complimentary admissions. Additionally, 3 fully supported places are available for patient representatives.

The DIA Europe Fellowship Programme is designed to:

Develop collaboration and improve alliances with different stakeholders Increase knowledge of issues at the heart of patient-centred healthcare and provide insight into the use of clinical trials by the pharmaceutical industry and regulatory authorities Enhance the capacity to respond to changes in drug development and health care delivery Stimulate mutual understanding and cross-culture co-operation, share best practices, and act as a platform for knowledge exchange and networking

Who should apply?

Representatives of non-profit patient groups in Europe in a leadership, staff or volunteer role Young professionals under the age of 32. Proof of age and status required with application Full-time students. Official confirmation of full-time student status required with application Part-time students are not eligible for fellowship, but can benefit from discounted student conference entry fees. Please contact DIA Europe on +41 61 225 5151 or email diaeurope@ diaeurope.org.

NOW ACCEPTING APPLICATIONS FROM PATIENTS, STUDENTS AND YOUNG PROFESSIONALS

Deadline: Friday, 9 August 2013

Selected candidates are expected to:

Attend the full Clinical Forum 89 October 2013 Participate in Fellowship activities at the conference Make use of the networking zone to meet other fellows and stakeholders Provide feedback afterwards on their experience

Part-Supported Fellowship (up to 25 available for Patients, Students, Young Professionals):

Complimentary registration for the 7th Annual Clinical Forum Complimentary admission to a pre-conference workshop

Fully Supported Fellowship (3 available, Patients only):

Complimentary registration for the Clinical Forum and a pre-conference workshop Return travel to and from Dublin (economy class) for one person Hotel accommodation for two nights

Selected candidates names will be published in the Final Programme and on the DIA website. DIA Europe will provide detailed information on acceptance to the Fellowship Programme by the week of 19 August 2013. For more information on the Fellowships, who should apply and the latest programme information, visit www.diahome.org/CF2013.

DIA Europe Fellowship 2013 Application Form for the 7th Annual Clinical Forum
I am applying for the Fellowship as a
Dr Mr Mrs Ms

Patient

Student

Young Professional

Last Name Organisation

_________________________________ First Name __________________________________________ _________________________________ Job Title/Role ________________________________________

Address _____________________________________________________________________________________ Postal Code Phone _________________________________ City ____________ Country ___________________________ _________________________________ Email Address _______________________________________

_____________________________________________________________________________________ Have you previously participated in a DIA EuroMeeting or the Clinical Forum ? If yes, which year? __________ If yes, did you have a Were you a speaker?

Full Fellowship? Yes

Free Entry? No

Which particular themes or scientific topics are of interest to you? (5 lines maximum)

I understand that English is the business language of the meeting and I am confident in my ability to participate
in the 7th Annual Clinical Forum 2013. Important: The number of fully supported places is restricted and available for Patients only. For a part-supported place you would be required to pay your own travel and accommodation costs. Would you still be willing to attend the conference? Yes No Do you have specific accessibility requirements? If yes, please specify _____________________

Yes No

Timeline: Deadline for submission of completed applications Notification of applicants Pre-Conference Workshop, Dublin 7th Annual Clinical Forum, Dublin 9 August 2013 Week of 19 August 2013 7 October 2013 89 October 2013

Please send the completed application to Maureen McGahan by email, mail or fax by Friday, 9 August 2013. Applications received after this date will not be considered. Important: Student and Young Professional applications have to be accompanied by proof of status e.g. course of study/position held and age. Maureen McGahan DIA Europe Kchengasse 16, Postfach 4002 Basel, Switzerland Maureen.McGahan@diaeurope.org

+41 61 225 51 60 (direct) +41 61 225 51 51 (customer services) +41 61 225 51 52 (fax)