29th ECNP Congress: Sponsorship for member

29th ECNP Congress
 
HKODA would like to sponsor one member of HKODA to attend "29th ECNP Congress" from 17th - 20th September 2016, in Vienna. Our sponsorship will cover the congress registration, economic class air ticket and hotel accommodation for the nominated delegates. Interested applicants please fill in the application form below and fax to 3747 9862 or Email to “momokoyu@yahoo.com.hk ”, Exco of HKODA.
 
Application form for Sponsorship of  “29th ECNP Congress" September 17th - 20th 2016, in Vienna.

 
Name:
 
Membership Number :     ______
 
1. Sponsored through HKODA with last  
 36 months  ○
 24 months  ○
 12 months  ○
 Never      ○
 
2. Active contribution in the association. If yes, please specify 
 
3. Specialty professional qualification ____________________________________

4. Experience relevant to criteria. If yes, please specify
 
5. Academic presentation at the conference. If yes, please specify
 
Deadline: 17th August 2016
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