VvE Student Award 2015
(Sent this application form, with a copy of registration to one of the universities
(maximum 1 year old) and your abstract to the Netherlands Epidemiological Society
(secretariaat@epidemiologie.nl).
Personal information
Personal data
Name:
Address:
Telephone number:
E-mail:
Man or woman:
Birthday:
Study
University:
Study:
Main subject:
Date of graduation:
Course
Division and place:
Supervisors:
Course period :
from
to
Short description of work within internship:
Sent or e-mail to:
Vereniging voor Epidemiologie, p/a Erasmus MC, Gebouw Ae, Kamer 407,
Postbus 2040, 3000 CA Rotterdam
secretariaat@epidemiologie.nl - www.epidemiologie.nl