To apply for a Bursary from the British Division of the International Academy of Pathology, please complete our online application form:

Application Form for BDIAP Nermin Durakovic Bursary to attend IAP XXXI International Congress, Cologne, 25th - 30th September, 2016

* = mandatory field, must be completed
Your name:*
Your address (For correspondence):*
Your address (Place of work, if different from the above):
Telephone (including STD and Extension):
Medical qualifications:*
Date of medical qualifications:*
Your date of birth:*
Your present age:*

Information about your laboratory

Population served by your laboratory:*

Total number of histopathology specimens per year:*

Autopsies per year:*

Number of full-time equivalent histopathologists (NOT trainees) covering the above workload:*

Information about your proposed trip

Conference days you wish to attend:*

Details of proposed oral or poster presentation. Please note that applications will not be considered without an abstract, which should be e mailed to Dr Nafisa Wilkinson, contact details on previous page*

What is the return fare (Economy) in Pounds Sterling between your nearest airport and an appropriate airport in the area of the meeting?*

Please give the names, postal addresses and (if available) email addresses of two pathologists, one of whom should be your Head of Department, who are willing to support your application with a reference.**

Give a BRIEF summary of your training so far, and your future plans. (maximum 100 words)*
Explain briefly how this experience would benefit your institution and the population it serves. (maximum 100 words)*
*Note - do not click the 'send' button more than once - thank you

We regret that it may not be possible to acknowledge receipt of applications. Successful applicants will be informed by post or email.