Application Form - India Giani Fund

advertisement
Scholarship Application Process
Meeting information:
Pediatric Academic Societies annual meeting, Baltimore, Maryland
April 30-May 3, 2016
Last date for submission of application to India Giani Fund is November 30, 2015
Requirements:
 Be a member of the Indian Academy of Pediatrics or NNF

Reside and practice in INDIA

Be a researcher in the area of Pediatrics or a Practicing Pediatrician in INDIA. Preference
will be given to those who will effectively promote bilateral exchange.

Submit Completed Application as PDF file. To ensure proper processing, please type or
write clearly and legibly.

Submit a recent copy of your Curriculum Vitae, this should include a list of
accomplishment and any publication that you have contributed in.

Deadline for submitting your abstract to PAS is November 10, 2015. Decision to
award scholarships will be made known by 31st December 2015 by the India Giani Fund
Committee.

Obtain a visa to enter the US. AAP will provide some of the needed documentation for
your review process, but each individual is responsible for additional material, and the
appointments process with the US consulate or embassy.

Two letters of recommendation from any of the following, from India or the US:
o
o
o
Head of Pediatric Department (or other Medical Department)
Dean or Principal of a University Pediatric/Medical program
Internationally Distinguished Pediatrician
• Willing to rotate in a major teaching NICU in USA for 2 weeks either
preceding or after the PAS annual meeting in a university hospital NICU as observer
Application:
Surname/Last Name:
First Name:
Degree: __ DR. __ PhD
__ MPH __Other, please specify: ___________________
Preferred address for mailing:
Street address: _________________________________
____________________________________
City: ________________________
PIN: ___________________
________________
State: __________________________
Country: INDIA
Job Designation: ___ Assistant Professor
Lead Researcher ___
________________
___ Professor ___ District Med Officer ___
Other, please specify: ________________________
Office Address: _______________________________________
City: ________________________
State: ____________________
__________________________
PIN: ____________________
Country: INDIA
Home telephone number: ______________________________________________
Mobile telephone number: ______________________________________________
Email address: ______________________________________________
Please send the completed applications, CV 500 word statement and reference letters by email in
one file, preferably PDF, to:
1.
Vasudeva Kamath MD MPH FAAP
Columbia University School of Medicine
New York, NY
@ [email protected]
and
2.
Mr Edgar Vesga, International Health, AAP
Email:[email protected]
Download