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2. Apply for the Event Grant and wait till annoucement of the successful grant applicants
before registering for World Congress, in this case, we will inform the reception committee
to waive your registration fee.
Note that if you opt to wait and are not successful for the grant, you will not be granted
a place in the Phase 1 registration if the quota is already filled.
This option is to assist with applicants, who may not have the funding to attend the World
Congress without the Event Grant.
For pharmacy students who are not eligable to register during phase 1 of World Congress
registration but intend to register in phase 2 or phase 3 of the registration period, you are also
required to apply for the grant by the same deadline, the 15th of February 2017 11:59pm GMT+0,
which will be prior to your world congress registration. If your grant application is successful, you will
be granted the event grant when you register.
4. Who is involved in the DF grant selection procedure?
4.1. The decision-making committee, who will consider valid applications, is the Development
Fund Committee which consists of three member representatives from three different countries, the
IPSF Treasurer and the Development Fund Coordinator, who chairs the committee.
This committee corresponds via email and discusses issues relating to the selection process and ways
to optimize the impact of the Development Fund grants at local and international levels.
Successful applicants will be notified by the Development Fund Coordinator before the 28th of
February 2017.
4.2. The applicant must be currently studying for their pharmacy undergraduate degree (first
pharmacy degree). An applicant may be an IPSF member through an IPSF Member Organization
(Full Member or Member in Association) or as an Individual Member.
Selected or not, an applicant is expected to provide accurate information and add any additional
information that would be relevant in the consideration of the application form.
If selected to receive the grant, a recipient is expected to:
Take an active part in IPSF activities and projects during and after the IPSF event attended.
If possible, deliver a presentation based on pharmacy practice and studies in their home
country during the IPSF event attended.
Produce a report addressed to the Development Fund Committee and to the IPSF Executive
detailing a review of the experience; what has been learnt and which IPSF projects/activities
are planned to be implemented in their country and why.
o This report must be sent no later than 1 month following the IPSF event attended.
Based on the report recipients may be required to write an article about pharmacy in their
country and/or the experience gained from attending the respective IPSF event, to be
published in the IPSF News Bulletin, IPSF Newsletter or on the IPSF website.
Keep in regular contact with the new IPSF Executive Committee after the congress to
maintain correspondence regarding what has been done in their country in order to maximize
the impact and benefits the experience will provide to other pharmacy students in that country.
Information relevant to the selection process was hidden from the Development Fund
Committee by the applicant.
Information stated by the applicant is later identified as being inaccurate or false and the
applicant failed to notify the Development Fund Committee about the necessary changes
required to the application.
New information concerning the financial situation of the applicant (and the relevant
member association, when applicable) was not provided (such as a new sponsor, more
money available than was originally stated, bigger amount of funds allocated by the
association to send the applicant to attend the event etc.).
Failure to submit the required documentation and/or receipts or submission of incomplete
documentation.
Other situations at the discretion of the Development Fund Committee.
IPSF Development Fund World Congress Event Grant: Application form 2017
Every Section of this application form must be completed in order to be valid. An application will only
be considered if sections A, B, C and D have been completed, and the declarations electronically
signed by inserting the relevant name.
Please complete the application form as a Microsoft Word Document and return this electronically via
email to the Development Fund Coordinator at df@ipsf.org before the 15th of February 2017 11:59pm
GMT+0. When returning your application, please rename the file to include the event you wish to
attend and your name, for example: WC2017 DF Application Form - Name
SECTION A
PERSONAL DETAILS
Full Name
Mr / Mrs / Miss
Full Address
Country
Nationality
Telephone Number
Fax Number
Email
Current Passport Number
Valid until:
Visa Requirements
Cost of Visa (Euros)
Time Required To Obtain Visa
Contact Information of relevant
embassy in your country
Contact person in the embassy you
have spoken to and title
STUDY DETAILS
Name of School of Pharmacy
at which you are studying
Address
Word Count
FINANCIAL DETAILS
Your National Currency
Exchange rate on 1 Euro ()
Exchange rate on 1 Euro ()
Verified by Treasurer on 15th Feb 2017
[TREASURER TO COMPLETE]
National Currency
Euro
Applicants Income
Scholarship/Grant Money
Loans, please specify
student or other
Fathers Income
Mothers Income
Family Allowance (money from family for
expenses)
Other sources of
income, please
specify
TOTAL
Yearly Expenditure (spent during the previous 12 months)
Income Type
National Currency
Euro
Rent or housing
Electricity, gas, water
Phone & Internet
Food & Groceries
Tuition
Books, stationary, school supplies
Clothing, shoes, personal hygiene
Other sources of
expenditure, please
specify
TOTAL
(Living expenses are considered as necessary costs for living that are paid by the applicant personally. For example food,
accommodation expenses (flat rent), electricity fees and study costs (books etc.) but not unnecessary costs like holidays)
National Currency
Euro
(Please complete the below table as appropriate detailing your estimated travel route and the
corresponding costs. Please note that only one row will need to be completed for a direct travel option.
However for a travel plan which involves a number of modes of transport each leg of the journey
should be listed on a separate row. For example: Row 1: Flight Amsterdam, The Netherland to Cairo,
Egypt; Row 2: Bus Cairo, Egypt to Hurghada, Egypt etc.)
Destination(each leg
of the journey on a
separate row)
Estimated Costs
(including return
travel)
SPONSORSHIP DETAILS
State the names of any bodies in your country which you have already contacted for sponsorship,
when you contacted them and the actual or possible results of the request (s):
SPONSOR
CONTACT DATE
RESULT
IPSF can give advice about approaching sponsors in your home country. Applicants are expected to
try and find sponsorship from other bodies apart from the IPSF Development Fund, and to explain why
if this has not been done.
SECTION B
MOTIVATION
In this section applicants should detail their reasons for applying for the grant; specifically
their reasons for attending the respective IPSF event, and also describe how attendance at
such an event would benefit other pharmacy students in their home country. Please also state
any additional information that may be relevant to the selection process, especially details
relevant to the Priority criteria stated in section 5.
As this section is seriously considered during the selection process, applicants are reminded of the
importance of stating clear and realistic reasons for their participation, with a focus on the personal,
national and international impact an IPSF event experience may create. The length of this motivation
should be no longer than 400 words.
Word Count
SECTION C
STUDENT ASSOCIATION DETAILS
(To be completed by the President and Contact Person)
Name of your National Association
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Name
Position
For the application to be valid, the most recent audited balance sheet of the
association must be submitted with the application.
We declare that:
1. The information stated above in Section C is to the best of our knowledge complete and accurate.
2. In the event of any changes in the information stated above, we will notify the Development Fund
Coordinator, without delay to prevent the potential withdrawal of the grant (if the application is
successful).
Signature
Date
Email Address
NATIONAL PHARMACY STUDENTS ASSOCIATIONS PRESIDENT
Signature
Date
Email Address
IPSF CONTACT PERSON
Signature
Date
Email Address
SECTION D
LETTER OF SUPPORT FROM SCHOOL OF PHARMACY
To be completed by the Head of School or Dean of the Department of Pharmacy at which the applicant
is studying. The Head of School or Dean should confirm that the statements made by the applicant in
Sections A and B of this form are complete and accurate therefore they must have seen a copy of
the completed application form. The letter of support should be attached as a separate Word
Document.
SECTION E
DECLARATION
I declare that:
1. I have read the guidelines and both understand their meaning and respect them.
2. I accept the consequences undertaken by the Development Fund Committee if I fail to respect
these rules
3. The information stated is to the best of my knowledge, complete and accurate.
4. I will notify the Development Fund Coordinator of any changes in the information stated above
without delay by email at df@ipsf.org.
5. I will make every effort to stimulate active interest in IPSF within my country.
6. I accept the fact that, in the case of my application being successful, the Development Fund
Committee reserve the right to withdraw the grant if any of the situations stated in the section
Situations and consequences of the above guidelines occurs.
7. If this application is successful, I will respect the duties of the applicant stated in the
guidelines written at the beginning of the application form (as per Section 4.2.)
APPLICANT
Signature
Date