TWAS-SAREP & KNAS Regional Young Scientists' Conference 2019
Apply to be a participant by fully completing the below form. Women Scientists from Least Developed Countries (LDCs) and Science & Technology Lagging Countries are highly encouraged to apply before the closing date, 23 August 2019.
1. Name (s) *
Your answer
2. Surname *
Your answer
3. What is your Title? *
4. Gender *
5. Date of Birth *
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6. Highest Qualification *
7. What is your Nationality? *
Your answer
8. Passport Number *
Your answer
9. Passport Issue Date *
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YYYY
10. Passport Expiry Date *
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11. Contact Number (s) *
Your answer
12. Working email address(es) *
Your answer
13. What is your occupation and where? *
Your answer
14. Home institution's physical address *
Your answer
EDUCATIONAL BACKGROUND
15. List your qualifications as follows: Name, Year awarded, Field / Discipline, University, Country. Starting with the most recent. *
Your answer
16. What is your Field of Specialisation *
17. Choose sub-theme for Oral abstract submission *
Type of Presentation *
18. What is the title of your proposed abstract (15 words)? *
Your answer
19. Insert your Abstract of 300 words (maximum) *
Your answer
20. Please motivate why you should be considered for this conference? (300 words) *
Your answer
21. List 3 of your most recent papers (relevant to the sub-themes) with their precise reference. *
Your answer
FUNDING
Due to budgetary constraints and the high demand for the Regional Young Scientist's Conference, Young Scientists are highly encouraged to consider partially funding for their participation (air travel) and the host will cater for local hospitality for the self-funded applicants.
22. Funding for Participants *
23. DECLARATION: I confirm that to the best of my knowledge that all the information provided is true and correct. *
REFERENCES
Please provide the names and addresses of two or three referees in support of your application.
Referee 1: Name, position, contact details (telephone, email) *
Your answer
Referee 2: Name, position, contact details (telephone, email) *
Your answer
Referee 3: Name, position, contact details (telephone, email) *
Your answer
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