2019 EASO Award Application Form

The deadline for receipt of completed award application forms is 25 January 2019 – late submissions will NOT be considered.

Personal details:

First name(s) Surname: 
Address: 
Telephone(s): 
E-Mail:   
Nationality: 
Date of Birth: 
Gender: 
Member National Association (see EASO website for a list of Member Associations): 

Please indicate which award you would like to apply for (application can be for more than one award):
  
Friedrich Wassermann Award
New Investigator Award for Basic Science
New Investigator Award for Clinical Research
New Investigator Award for Public Health
New Investigator Award for Childhood Obesity Research
New Investigators United Best Thesis Award
EASO Travel Grant
Youth Hostel Accommodation


Please tick below, additional items submitted with your application:

Award application:

Please justify in no more than 300 words why you should receive the EASO award, for which you are applying. Please see the EASO website for guidance.

Evidence of your most important publications, awards and involvement with your National Obesity Association should be highlighted. Please attach documents that you feel would be relevant to back up your application (e.g. full publication list).

 

Work Experience (most relevant and recent):

Dates: 
Occupation or position held: 
Main activities and responsibilities: 
Name and address of employer: 
Type of business or sector: 

Education and Training (most relevant and recent):

Dates: 
Title of qualification awarded: 
Principal subjects/ occupational skills covered: 
Name and type of organisation providing education and training: 
Level in National or International classification: 

N.B: If you do not receive receipt of your application within 48hrs of submission, please contact the EASO Secretariat.