application form-youth-pre-wha.docx

7/29/2019 Application Form-Youth-Pre-WHA.docx

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Youth Pre-World Health Assembly Application Form

Dear Global Health Enthusiasts,

We are pleased to warmly invite you to apply to the Youth Pre-World Health Assembly

(Pre-WHA), which will be held between May 16th-20th, 2013 in Geneva, Switzerland.

Application Requirements

Be between 17 and 29 years old

Regional representation and diversity, especially with emphasis on reaching

global south

Have previous knowledge and active experience in one or more of thefollowing topics: international relations, global health, advocacy, leadership,

public health

Be proficient in English (both written and spoken)

Be expected to attend and participate actively within the Pre-World HealthAssembly and World Health Assembly Event May 16th-28th.

Be committed towards engaging actively in the follow-up process of the event,

which includes, but not limited to, submitting in-depth reports and

participating in follow-up surveys.

Submit a complete application form by April 1st,2013.

Participation Fees

Conference Participation Fee: 430 Euros.

The participation fee is all-inclusive and covers the venue, programming, breakfast,

lunch, dinner as well as housing during the Pre-World Health Assembly between May

16th-20th.

Please note, that the Organizing Committee does not provide accommodation for the World Health Assembly

(May 20th -28th). Please write the organizing committee, should you need accommodation for the World

Health Assembly (May 20th-28th), as we might be able to assist you in finding housing for that time.

Application Deadline

Please fill out this form and send it back to us via email byApril 1st, 12.01pm GMT.

Email Address:[email protected].

For any further questions, please feel free to contact us anytime.

Yours Sincerely,

The Organizing Committee of the Youth Pre-World Health Assembly
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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General Information

Your Name:

Email Address:

Organization that you represent:If you do not represent any Organization write N/A

Your Country:

Date of Birth (DD/MM/YYYY):

Gender (Male/Female):

Passport Number:

Passport Issuing Country:

Issuing Country:

Issue Date:

Expiration Date:

Will you be able to attend the Pre-World Health Assembly (May 16 th-20th)? (Yes/No):

Will you be able to attend the World Health Assembly (May 20th-28th)? (Yes/No):

Will you require financial assistance to attend the meeting? (Yes/No):Please note that travel funds are limited and will depend on the amount fundraised by the organizing committee.

Will you be able to attend the meeting in the case you should not receive financial aid from

the Organizing Committee? (Yes/No):

The Organizing Committee in any case will be able to provide you assistance in fundraising for yourself by sending letters of support and template

letters to address to your university, country office, etc.


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Motivation LetterPlease share your motivation to attend the Pre-World Health Assembly and/or the

World Health Assembly (maximum 1 page)


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Plans for the MeetingPlease share your concrete Plans for Pre-World Health Assembly and/or the World

Health Assembly (maximum 1 page). Please be as specific as possible.


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Curriculum VitaePlease Provide a relevantCurriculum Vitae (maximum 2 pages):

application form-youth-pre-wha.docx

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