HIV Glasgow 2022: Scholarship Application Form

The HIV Glasgow Congress is pleased to offer the opportunity for those working in the field of HIV to apply to attend the October 2022 congress virtually. Applications are invited both from those working in resource poor settings and working with patient groups and organisations, across the globe.

Please complete the application form below if you wish to be considered for one of these virtual registrations. The application form should be completed in English and you will be required to upload a CV in support of your application.

The closing date for applications is Monday 22 August 2022.

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* 1. Please indicate the type of scholarship you are applying for:

Resource poor setting

Community partner

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* 2. Please provide your contact details for this application

Title (Dr, Mr, Mrs, Prof, Other) *

First Name *

Family Name *

Name of Health Care Facility or Organisation/Institution *

City/Town *

Country *

Email address *

Telephone number *

Organisation/Institution Website (if there is one)

Twitter Name (if you have one)

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* 3. Please indicate your profession:

Activist

Community Support Worker

General Practitioner

Midwife

Nurse

Patient

Pharmacist

Physician

Other (please specify)

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* 4. How long have you worked in the field of HIV/AIDS?

Up to 2 years

Between 2 and 5 years

More than 5 years

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* 5. Overall how many patients are seen at or supported by your health care facility/community organisation annually?

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* 6. Please indicate the approximate number of patients you personally support/see per month:

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* 7. Please indicate if you have attended other HIV/AIDS Congresses in the past where you have received financial support to facilitate your attendance. Please list up to four most recent events you have attended.

Event 1:

Event 2:

Event 3:

Event 4:

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* 8. Why would you like to participate in HIV Glasgow 2022?

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* 9. Please describe your current job and primary areas of interest in HIV/AIDS and how the scholarship will help you in your day-to-day activities.

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* 10. Please share information on whether you have the facility within your organisation/institution to share the information gained at HIV Glasgow 2022.

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* 11. Please upload a copy of your CV to assist the reviewers to evaluate your application.

Please upload your CV

PDF, DOC, DOCX, JPG, JPEG file types only.

Choose File

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* 12. Data Protection and Terms of Application

I understand that the information supplied in this application will be stored electronically by Ashfield Health

If I am successful but I subsequently receive a virtual registration from another source I will inform the Congress so that the virtual registration can be redistributed to another applicant

I confirm that the information supplied within this form is accurate and complete and I understand that the information provided will be sent out to reviewers assessing applications

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