Scholarship submission form
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Name
Title
Title
- Select -
Miss
Ms
Mr
Mrs
Dr
Other…
Enter other…
First Name
Last Name
Contact Email
Address
City/Town
State
Do you work or volunteer for a community based organisation
- Select -
No
I work for a community-based organisation
I volunteer for community-based organisation
I am engaged in my community advocacy or support activities
If you responded yes to the above question, please provide details below (including the organisation name if relevant)
Can you please describe how you meet each of the selection criteria specified in the guidelines?
Do you require funding for accommodation to attend the conference? Please indicate which dates you require accommodation
20 November
21 November
22 November
UNSW CSRH will book your travel and accommodation. Please note that we cannot reimburse bookings that you have made yourself for travel and accommodation.
Do you require funding for travel to attend the conference? (Note that this conference is being held in Sydney)
Yes
No
Where will you be travelling from?
Do you require Cabcharge vouchers for travel to/from airport locations?
Yes
No
Do you have any other requirements, that you may need assistance with, to attend the conference?
Yes
No
Please provide additional details
If you do not receive this scholarship, would you still be able to attend the conference?
Yes
No
How will your presence at the conference assist your community?
Why is addressing stigma in health care settings important to you?
Please upload your letter of support to attend the conference here
One file only.
30 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, ppt, pptx, xls, xlsx.
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