Non-Society Symposium Grant Application

1. Non-Society Symposium Grant application

100%

This is a one page application, and once you have submitted this, you will not be able to make any amendments.

Your application will be compiled and sent to a Committee for review. In its review, the Committee will bear in mind the physiological relevance of the application, how this would further the charitable objectives of The Society, whether a particular meeting - or a particular applicant - has been awarded funds through the scheme in the past.

All Symposia supported under this scheme must be organised by an Ordinary Member(s) or have an Ordinary Member closely involved with planning the meeting.

Note: Personal data provided on this form may be held and processed on The Society's database. A summary of The Society's data protection policy, including the rights of subjects upon whom data is held, is obtainable.

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1. First Organiser Details

First Organiser Details First Name:
Surname:
Institution:
Department:
Email:
Society Membership No. (if applicable):

2. Second Organiser Details (if applicable)

Second Organiser Details (if applicable) First Name:
Surname:
Institution:
Department:
Email:
Society Membership No. (if applicable):

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3. Symposium Details

Symposium Details Title:
Date:
Location:
URL or contact email:
Brief statement on symposium topic:

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4. Please indicate which Theme best represents your Symposium topic

Please indicate which Theme best represents your Symposium topic Cardiac & Respiratory Physiology

Cellular & Integrative Neuroscience

Epithelia & Membrane Transport

Human & Exercise Physiology

Metabolism & Endocrinology

Vascular & Smooth Muscle Physiology

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5. Provisional Scientific Programme - speakers, title of lectures, institutions (NB you may also email the programme to ccarr@physoc.org, then please enter 'emailed' in this field):

Provisional Scientific Programme - speakers, title of lectures, institutions (NB you may also email the programme to ccarr@physoc.org, then please enter 'emailed' in this field):

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6. How will this symposium further the charitable objectives of The Society? Further information on the charitable objectives can be found here: http://www.physoc.org/site/cms/contentChapterView.asp?chapter=103

How will this symposium further the charitable objectives of The Society? Further information on the charitable objectives can be found here: http://www.physoc.org/site/cms/contentChapterView.asp?chapter=103

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7. What level of support are you seeking? (up to a maxiumum of £1500) Please provide detailed financial breakdown. Please note that this scheme is not intended to replace The Society's travel grant scheme. For more information on travel grants, please visit: http://www.physoc.org/site/cms/contentCategoryView.asp?category=348

What level of support are you seeking? (up to a maxiumum of £1500) Please provide detailed financial breakdown. Please note that this scheme is not intended to replace The Society's travel grant scheme. For more information on travel grants, please visit: http://www.physoc.org/site/cms/contentCategoryView.asp?category=348

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8. Details of funds requested and, where appropriate, a brief justification

Details of funds requested and, where appropriate, a brief justification Travel:
Accommodation:
Subsistence:
Other:
Total Grant Requested (max £1000):

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9. Breakdown of other expected income (give details of other applications for funding, donations received, or income from registration fees, if appropriate):

Breakdown of other expected income (give details of other applications for funding, donations received, or income from registration fees, if appropriate):

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10. Proposed ‘concessions’ available to Society Members and Affiliates attending the symposium:

Proposed ‘concessions’ available to Society Members and Affiliates attending the symposium:

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11. Have you applied for and received funding under this Scheme in the past? (Those who have not may receive priority allocation.)

Have you applied for and received funding under this Scheme in the past? (Those who have not may receive priority allocation.) Yes

If yes, please provide details (symposium/meeting title and date, grant amount and year of award):

Non-Society Symposium Grant Application

1. Non-Society Symposium Grant application

*1. First Organiser Details

2. Second Organiser Details (if applicable)

*3. Symposium Details

*4. Please indicate which Theme best represents your Symposium topic

*5. Provisional Scientific Programme - speakers, title of lectures, institutions (NB you may also email the programme to ccarr@physoc.org, then please enter 'emailed' in this field):

*6. How will this symposium further the charitable objectives of The Society? Further information on the charitable objectives can be found here: http://www.physoc.org/site/cms/contentChapterView.asp?chapter=103

*8. Details of funds requested and, where appropriate, a brief justification

*9. Breakdown of other expected income (give details of other applications for funding, donations received, or income from registration fees, if appropriate):

*10. Proposed ‘concessions’ available to Society Members and Affiliates attending the symposium:

*11. Have you applied for and received funding under this Scheme in the past? (Those who have not may receive priority allocation.)