Education and Training Department Sir William Lister and Dorey Bequest Travel Awards 2015 Closing date: Wednesday 23 September 2015 Multiple awards of £300 – £600 The Education Committee of the Royal College of Ophthalmologists has become responsible for a number of travel awards in recent years. The administrative process for the above two travel awards has been amalgamated for the purposes of application. i. ii. iii. iv. i. ii. iii. iv. v. Please note: Applicants will be considered for a travel award but will be awarded from one fund only (e.g. you cannot receive a travel award from the Dorey Bequest and Sir William Lister). Those who receive a travel award will be informed from which fund their award is from. Those who have received a travel award from the Ethicon Foundation Fund are not eligible to apply. Retrospective applications will not be considered. General Information: The Royal College of Ophthalmologists has undertaken the role of trustee and administrator for the funds. For Sir William Lister, this has been assumed from the Royal College of Surgeons of England. The travel awards will be made by the Education Committee of the Royal College of Ophthalmologists. The award is for ophthalmologists in training who are citizens of the United Kingdom as well as Members and Fellows of the Royal College of Ophthalmologists, in good standing. Successful applicants will submit a report to the Education Committee on completion of the period of training or research for which the award is granted. The number and value of the awards will be determined by the state of the funds and the candidate's requirements; the amount awarded is generally between £300 and £600 ii. Sir William Lister: Founded in 1948 with a gift of £3,000 by Lady Lister in memory of her husband, Sir William Tindall Lister KCMG KCVO. The title of the award shall be the Sir William Lister Award in Ophthalmology. i. ii. Dorey Bequest: Founded in 1992 with a gift of £17,000 from Mr Corry James Dorey. The title of the award shall be the Dorey Bequest. i. Please email an electronic version of your completed application form and CV to: Daniah.Ahmed@rcophth.ac.uk . In addition to this, please post 4 hard copies of your application form and CV to: Daniah Ahmed Education and Training Administrator The Royal College of Ophthalmologists 18 Stephenson Way London NW1 2HD (Your application will be disqualified unless we receive both electronic and hard copies of your application form and CV.) CLOSING DATE FOR APPLICATIONS: Wednesday 23 September 2015 Sir William Lister and Dorey Bequest Travel Awards Application Form Closing date: Wednesday 23 September 2015 Personal Details Title Name Surname Email Address Mobile Number College Membership Number National Training Number (NTN) Qualifications held Work Address Tel No Fax No Post Held Address for correspondence (if different from above) Details of Visit Start date Duration Title of Fellowship/Research Project Place of Fellowship/Research Project Financial Statement Cost of Travel Does the post attract a salary? (If yes, please indicate amount) Will a UK salary be retained? (If yes, please indicate amount) Other grants/fellowships obtained or being sought Nature and purpose of proposed visit: (N.B. This should include aims and objectives of the visit/research and suitability of the centre to be visited or to accommodate the research. Please note that this page must be used for a summary but an appendix can be attached if it is felt necessary.) THIS SECTION IS TO BE COMPLETED BY CURRENT UK TRAINER / HEAD OF DEPARTMENT Statement of support Name Title Signature Date