IPTA Outreach Program Application 2024 General Information Question Title * Email Address Question Title * Name, Affiliation and contact information of applicant. Question Title * Current designation and department. Question Title * Are you a current IPTA member? (You need to be a current IPTA member in good standing to be eligible to apply. Please go to https://tts.org/ipta-members-area/ipta-join to become an IPTA member or to pay your dues. Your application will not be valid unless you are an IPTA member or have submitted an application to join IPTA) Yes No Question Title * Do you currently reside in a low income or low middle income country as defined by this list https://tts.org/member-area/member (see list of emerging economy nations). If no, your application is invalid. Yes No Question Title * Are you or is your institution currently signed up to the Declaration of Istanbul? (You or your institution needs to be signed up to the Declaration of Istanbul Custodians Group to be eligible to apply. Please go to http://declarationofistanbul.org/ to sign up. Your application will not be valid unless your institution is signed up to the DICG or has submitted an application to join the DICG) Yes No Question Title * Do you have a mentor or host centre in mind for a proposed partnership? Yes No Question Title * If Yes: add name, affiliation, designation and contact information of proposed mentor. Next