Home LP2023 Bursary Application Form (Trainees) Please complete the form below to apply for a bursary to attend Liverpool Pathology 2023. You must ask your Clinical Lead / Head of Department / Laboratory Manager / Line Manager (as appropriate) to complete and submit the Verification Document, which can be downloaded below. The verification form must be submitted by email to Louisa Coulthurst in order to complete your bursary application. Verification Document (PDF) Verification Document (Word) Liverpool Pathology will take place at The University of Liverpool on 27-29 June 2023. *TitleTitle required *First NameFirst Name required *SurnameSurname required *Date of BirthDate of Birth required *Address Line 1Address Line 1 required Address Line 2 Address Line 3 *TownTown required County *Postcode/ZIPPostcode/ZIP required *CountryCountry required *PhonePhone requiredInvalid phone *EmailEmail requiredInvalid email *IAP Reference NumberIAP Reference Number required *QualificationsQualifications required *National Training NumberNational Training Number required *Which year of training are you in?FirstSecondThirdForthFifthOtherWhich year of training are you in? required If Other, please specify *Date of Training CompletionDate of Training Completion required *Present PostPresent Post required *Trust/Institute of Present PostTrust/Institute of Present Post required *How would I benefit from being awarded a BDIAP bursary? How would I benefit from being awarded a BDIAP bursary? required *Name and Email Address of current Clinical Lead/Head of Department who will complete and submit the verification form Name and Email Address of current Clinical Lead/Head of Department who will complete and submit the verification form required *Have you submitted an abstract for the meeting?YesNoHave you submitted an abstract for the meeting? required Please upload a copy of your abstract *Have you applied for a bursary elsewhere? YesNoHave you applied for a bursary elsewhere? required If Yes, please give details *Declaration I understand that my data will be stored by the BDIAP and I may be contacted in the future by the BDIAP on matters relating to this application and/or my membership. This data will be stored in accordance with the BDIAP's data privacy policies. Your data may be shared with the Pathological Society and the congress organiser, Abbey Conference & Events, for the purpose of Liverpool Pathology 2023 only. I may request that my data is deleted at any time using the data deletion request form in the data privacy policies section of the website however I understand that my data is stored as a contractual necessity of my application/membership of the BDIAP so that if I ask for my data to be deleted this will also mean that I am cancelling my membership and/or withdrawing my application.Declaration required Please complete the Google reCAPTCHA