IPSF Development Fund 2010-2011: Event Grant

Guidelines for Development Fund ApplicantsPlease read carefully before completing the application form

1. Background

The main goal of the Development Fund is to give each and every pharmacy student an equal opportunity to fully participate in IPSF activities. This opportunity is also intended to help promote IPSF within their Schools of Pharmacy and countries. The Development Fund was initially created with the aim of supporting students who were unable to attend an IPSF event because of financial reasons. Currently the Development Fund may also be used to pay the IPSF Annual Membership Fee of organisations from low or lower middle income countries (as defined by the World Bank) and developing nations (as defined by the United Nations), to financially support IPSF activities undertaken by members and participation in IPSF events and to award Student Exchange Programme Grants.

This is the official application form for participation in the following IPSF events during 2011:

1. The 10 th IPSF Asia-Pacific Pharmaceutical Symposium (APPS), Yogyakarta, Indonesia, 2 nd July — 7 th July 2011. 2. The 2 nd IPSF Eastern Mediterranean Regional Symposium (EMPS), Doha, Qattar, 15 th July—22 nd July 2011.3. The 57 th IPSF World Congress, Hat Yai, Thailand , 3 rd – 13 th August 2011.

Please note: Plans for the IPSF Pan-American and African Regional Symposia have not been finalized. When applications for these events are open, the Development Fund Committee will announce a separate application period.

Completing this application form means that you have decided to embrace this opportunity and play an active role in IPSF, locally, nationally, and internationally. Congratulations! However, it is essential that applicants understand this grant is given to a student to allow him/her promote IPSF in their home country on returning from an IPSF event – not as a free holiday. These guidelines were designed to ensure that potential applicants are fully aware of the selection process and also accept the expectations, restrictions and consequences of an application. The grant is awarded to attend the IPSF Annual Congress or an IPSF Regional Event as stated above and may cover part or full travel expenses (bus, train or plane tickets) from the applicant’s home country to the event and/or the event registration fee. 2. Completion of the application form

Please ensure the application form is completed accurately with any other information relevant to the selection process being added to the form. Every section must be completed for the application form to be considered valid. Applicants must submit an electronic version of the application form prior to the closing date (15th March 2011) before any applications will be considered complete. The electronic version should be emailed directly to the Development Fund Co-ordinator (df@ipsf.org).

3. Who is involved in the DF grant selection procedure

3.1. The decision-making committee, who will consider valid applications, is the Development Fund Committee which consists of three member representatives from three different countries, the IPSF Treasurer and the Development Fund Co-ordinator who chairs the committee. This committee corresponds via email and discusses issues relating to the selection process and ways to optimise the impact of the Development Fund grants at local and international levels.

Successful applicants will be notified by the Development Fund Committee before the 5th April 2011.

3.2. The applicant is the student applying for a grant, who is a member of IPSF. Selected or not, an applicant is expected to provide accurate information and add any additional information that would be relevant in the consideration of the application form. If selected to receive the grant, a recipient is expected to:

Take an active part in IPSF activities and projects during and after the IPSF event attended. If possible, deliver a presentation based on pharmacy practice and studies in their home country

during the IPSF event attended. Produce a report addressed to the Development Fund Committee and to the IPSF Executive

detailing a review of the experience; what has been learnt and which IPSF projects/activities are planed to be implemented in their country and why. This report must be sent no later than 3 months following the IPSF event attended.

Based on the report recipients may be required to write an article about pharmacy in their country and/or the experience gained from attending the respective IPSF event, to be published in the IPSF News Bulletin, IPSF Newsletter or on the IPSF website.

Keep in regular contact with the new IPSF Executive Committee after the congress to maintain correspondence regarding what has been done in their country in order to maximise the impact and benefits the experience will provide to other pharmacy students in that country.

4. Grant coverage and criteria

The awarded grant will cover either the event registration fee, part of the travel expenses (bus, train or plane tickets and visa costs), full amount of travel expenses or any combination of these. In the event of the actual costs incurred being less than the awarded grant then only the amount of actual costs will be paid. The grant will be preferably paid by bank transfer after participating in the event and submitting the required documents. In special cases the grant may also be paid to the recipient at the event by cash.

The total number of grants awarded will be decided after the deadline for receipt of applications and will be dependent on the total number of quality applications received and on the grant budget available.

Priority will be given to:i) applicants from low or lower middle income countries (as defined by the World Bank) or from developing countries (as defined by the United Nations); ii) those who have served IPSF as a Contact Person, Student Exchange Officer, subcommittee member or in some other way contributed to IPSF projects;iii) for regional symposia, applicants who are from the same region;iv) and those who will be attending an IPSF event for the first time and/or are the only representatives from their countries.

Representatives of organisations who will apply for IPSF membership at the World Congress may also apply for this grant.

5. Issues to be taken in the consideration

5.1. Visas: It is essential applicants establish whether they require a visa to attend the respective IPSF event and begin the necessary steps in order to be ready to apply quickly, in the event that the application is successful and a grant is awarded. No grant will be given to an applicant before obtaining the visa(s) required to travel to the country where the IPSF event will occur. Sadly, this issue often prevents recipients from actually attending the IPSF event. So please, be prepared if a visa is required and collect any relevant documentation and information needed for a visa request in advance to accelerate the procedure within the Embassy.

5.2. Sponsors: Applicants should look for sponsorship as soon as they start thinking of going to the IPSF event. National, local and private bodies often have a budget to support students with these kinds of initiatives. The Development Fund exists to help but rarely gives a grant that covers all of the expenses involved. It is advised that initial steps with potential sponsors are begun immediately as it often takes a long time period before an answer is received - one might even be surprised and obtain more sponsorship than was originally thought!

6. Situations and Consequences

To avoid any misunderstanding of the procedure, misuse of the grant or reduction in the grants awarded each year, this section has been added to dissuade any potential applicant from hiding any relevant information or from providing incomplete or false information on their application form.

It is an applicant’s responsibility to inform the Development Fund Co-ordinator of any changes in the information stated in the application form as soon as the applicant is aware of any new information. It is recommended that all applicants retain a copy of their application form to remember what has been stated in the application. If any changes of circumstances occur after submitting the application form please inform the Development Fund Co-ordinator as soon as possible. Any applicant awarded a DF grant and later found to have misused funds will not be eligible to receive any DF Grant in the future. If the grant has been paid before the misuse has been identified then the applicant must pay the grant fully or partly back to the IPSF Development Fund as determined by the Development Fund Committee and IPSF Executive.

The Development Fund Committee reserves the right to withdraw or reduce any grant given to an applicant in the event of any of the following situations arising:

More than one student from the same country and/or organisation as a DF Grant recipient attends or registers to attend the same IPSF event as the recipient without prior notification to the Development Fund Co-ordinator.

Information relevant to the selection process was hidden from the Development Fund Committee by the applicant.

Information stated by the applicant is later identified as being inaccurate or false and the applicant failed to notify the Development Fund Committee about the necessary changes required to the application.

New information concerning the financial situation of the applicant (and the relevant member association, when applicable) was not provided (such as a new sponsor, more money available than was originally stated, bigger amount of funds allocated by the association to send the applicant to attend the event etc).

Failure to submit the required documentation and/or receipts or submission of incomplete documentation.

Other situations at the discretion of the Development Fund Committee.

7. Declaration:

I declare that:

I have read these guidelines and both understand their meaning and respect them.I accept the consequences undertaken by the Development Fund Committee if I fail to respect these rules.

Signed:      

Date:      

IPSF Development Fund Event Grant: Application form 2010-2011

Every Section of this application form must be completed in order to be valid. An application will only be considered if sections A, B, C and D have been completed, and the declarations electronically signed by inserting the relevant name.

Please complete the application form as a Microsoft Word Document and return this electronically via email to the Development Fund Co-ordinator at df@ipsf.org before the 15th March 2011. When returning your application, please rename the file to include the event you wish to attend and your name, for example “IPSF_DF_Event_Grant_2011_Application_Form_APPS_John_Lee”

Application for a grant to enable attendance at: (Please delete or tick as appropriate)

The 10 th IPSF Asia-Pacific Pharmaceutical Symposium (APPS), Yogykarta. Indonesia, 2 nd July — 7 th July 2011.

The 2 nd IPSF Eastern Mediterranean Regional Symposium (EMPS), Doha, Qattar, 15 th July—22 nd July 2011.

The 57 th IPSF World Congress, Hat Yai , Thailand, 3 rd – 13 th August 2011.

SECTION A:

PERSONAL DETAILS:

Full Name: (Mr/Mrs/Miss)      

Full Address:      

     

     

     

Country:      

Nationality:      

Telephone Number:      

Fax Number:      

Email:      

Current Passport number:      

Valid until:      

Visa Requirements:      

Cost of the Visa: (Euros)      

Time required to obtain Visa:      

Contact information of the relevant embassy in your country:      

Contact person in the embassy you have spoken to and title:      

STUDY DETAILS:

Name of School of Pharmacy at which you are studying:      

Address:      

Qualification you will receive:      

Total length of course:      

Date of graduation:      

INVOLVEMENT WITHIN YOUR NATIONAL ASSOCIATION AND WITHIN IPSF:

(Maximum 500 characters)

     

FINANCIAL DETAILS :

Your national currency:      

Exchange rate on 15th March 2011: 1 Euro (€) =      

(Exchange rate will be completed by the IPSF Treasurer, please do not fill in)

Income received during the previous 12 months:

Personal:      

Family Allowance:      

Grants (for example: Scholarship /Governmental Support):      

Other sources:      

Additional income expected in the next 12 months:      

Living expenses (approximately) per year:      

(Living expenses are considered as necessary costs for living that are paid by the applicant personally. For example food,

accommodation expenses (flat rent), electricity fees and study costs (books etc) but not unnecessary costs like holidays)

Estimated travel and visa expenses to attend the IPSF event (state for return journey):      

(Please complete the below table as appropriate detailing your estimated travel route and the corresponding costs. Please note that

only one row will need to be completed for a direct travel option. However for a travel plan which involves a number of modes of

transport each leg of the journey should be listed on a separate row. For example: Row 1: Flight Mumbai to Kuala Lumpur; Row 2: Bus

Kuala Lumpur to Penang etc)

Destination(each leg of the journey on a separate row)

Estimated costs (including return travel)

Route and means ofTransportation

Source of the information(Website/travel agency etc)If you have an electronic document please attach it

                       

                       

                       

                       

SPONSORSHIP DETAILS:

State the names of any bodies in your country which you have already contacted for sponsorship, when you

contacted them and the actual or possible results of the request(s):

     

IPSF can give advice about approaching sponsors in your home country. Applicants are expected to try and find sponsorship from other bodies apart from the IPSF Development Fund, and to explain why if this has not been done.

SECTION B:

MOTIVATION:

In this section applicants should detail their reasons for applying for the grant; specifically their reasons for attending the respective IPSF event, and also describe how attendance at such an event would benefit other pharmacy students in their home country. Please also state any additional information that may be relevant to the selection process, especially details relevant to the Priority criteria stated in section 4.

As this section is seriously considered during the selection process, applicants are reminded of the importance of stating clear and realistic reasons for their participation, with a focus on the personal, national and international impact an IPSF event experience may create. The length of this motivation should be no longer than 400 words.

     

I declare that:

1. The information stated is to the best of my knowledge, complete and accurate.

2. I will notify the Development Fund Co-ordinator of any changes in the information stated above without delay by email at df@ipsf.org.

3. I will make every effort to stimulate active interest in IPSF within my country.

4. I accept the fact that, in the case of my application being successful, the Development Fund Committee reserve the right to withdraw the grant if any of the situations stated in the section “Situations and consequences” of the above guidelines occurs.

5. If this application is successful, I will respect the “duties of the applicant” stated in the guidelines written at the beginning of the application form (as per Section 3.2.)

Signed:       Date:      

SECTION C:

STUDENT ASSOCIATION DETAILS: (to be completed by the President and Contact Person)

Name of your national association:      

Address of your association:      

     

     

     

Name of the IPSF Contact Person:      

Tick or delete the following responses as appropriate:

Can this association contribute to your expenses? Yes No

If yes, how much?      

Are you an Official Delegate? Yes No

Are any other persons (graduated, student, others) from your country attending? Yes No

If yes, are they a) students from your local student association? Yes No

b) members of your national association? Yes No

Names and positions of attending persons:

     

We declare that:

1. The information stated above in Section C is to the best of our knowledge complete and accurate.

2. In the event of any changes in the information stated above, we will notify the Development Fund Co-ordinator, Beth Aubrey, without delay to prevent the potential withdrawal of the grant (if the application is successful).

For the application to be valid, the most recent audited balance sheet of the association must be submitted with the application.

Local students association’s President:

Signed:      

Email address:      

National pharmacy students association’s President:

Signed:      

Email address:      

IPSF Contact Person:

Signed:      

Email address:      

SECTION D:

LETTER OF SUPPORT FROM SCHOOL OF PHARMACY:

To be completed by the Head of School or Dean of the Department of Pharmacy at which the applicant is studying. The Head of School or Dean should confirm that the statements made by the applicant in Sections A and B of this form are complete and accurate – therefore they must have seen a copy of the completed application form. The letter of support should be attached as a separate Word Document.