DDD 2017 Grant Application Form
Part A: Applicant Personal Details
Title
Last Name
Your answer
First Name
Your answer
Gender
Status
Required
Date of birth
(dd/mm/yy)
Your answer
Nationality
Your answer
Passport number
Your answer
Residence
City and Country of current residence
Your answer
Have you attended previous DDD conferences?
Is this your first visit to Israel?
Have you received grants from the DDD conferences before?
Part B: Contact Information
E-mail address
Your answer
Phone Number
please include country code
Your answer
Additional Phone Number
please include country code
Your answer
Fax Number
please include country code
Your answer
Part C: Professional Affiliation
Type of Organization
(Academic/ NGO/ Government/ Business)
Your answer
Name of Organization
Your answer
Organization web-site:
Your answer
Your position in the Organization
Your answer
Your field(s) of work/expertise
you may choose more than one field and add other fields at the end
Required
Description of organization's relevance to DDD conference
please describe what is the connection between your organization and the fields of drylands, deserts or desertification
Your answer
Part D: Additional Information
please answer the following questions to help us determine your relevance and possible contribution to the DDD conference, as well as to assess the level of your needs
Title of your proposed presentation
please provide a tentative title for your presentation at the conference. please note that this is a requirement for all grantees.
Your answer
Type of assistance needed
please choose below. Kindly note that by choosing a limited assistance program, you are increasing your chances of obtaining a positive answer
If requesting a partial grant, what is most essential for you?
please choose below. Kindly note that by choosing a limited assistance program, you are increasing your chances of obtaining a positive answer
Part E: Professional Recommendations
Please provide at least one name of a professional in the field that can recommend your participation.
If you have an Israeli host or colleague, please provide their name and contact details
Title, Last name, First name
Your answer
Organization
Your answer
e-mail
Your answer
Phone number
Your answer
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