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13th South East Asia Congress of Medical Physics 2015
10 - 12 December 2015, Yogyakarta, Indonesia Secretariat of SEACOMP 2015: Jl. Ganesa 10, Lab. Biofisika, Fisika, FMIPA, ITB,
Email: [email protected] Website: http://www.medphys.fi.itb.ac.id/seacomp2015
TRAVEL AWARDS
Goals of the Awards
1. To assist medical physicists in the SEAFOMP region to attend and present their work
at the 13th SE ACOMP.
2. To foster international co-operation in the field of medical physics between
SEAFOMP member countries.
The Awards
There are 5 grants and US$ 200 for each successful applicant from within SEAFOMP
countries and outside host country.
Mandatory Requirements
1. The applicant shall be a young medical physicist currently practicing in a SEAFOMP
member country
2. The applications shall be verified and endorsed by the respective SEAFOMP member
organizations (this condition may be exempted for applicants from countries where
medical physics organizations do not exist); and
3. The applicant shall have at least one abstract accepted for presentation at the 13th
SEACOMP, and
4. The awardee shall register and attend the Congress in person; and
5. The awardee shall submit a short report by January 31, 2016 to the SEAFOMP
Secretary-General and to the awardee’s Medical Physics Association/Society on what
was learnt at the Congress and how he/she intends to apply that in his/her own
country.
Selection Criteria
Higher priority will be given to the following:
1. Applicants from developing countries/areas.
2. The level of responsibility in performing and/or supervising others to perform medical
physics service.
3. The value to the applicants in promoting medical physics in their
institutions/countries in attending the congress.
4. Applicants who have less opportunity of attending overseas training/conferences.
5. Applicants who have not received any SEAFOMP/ AFOMP travel awards before.
6. Applicants with higher quality abstracts
Application Procedure
1. Applicants should complete the application form given below.
2. Complete application form must be sent by email to: Prof. K. H. Ng as Chair of
Travel Award Committee at [email protected] on before October 31, 2015
3. Applications received shall be considered by the Awards & Honors Committee,
whose decision shall be final. Applicants should provide in their applications all
relevant information for assessment by the Committee.
13th South East Asia Congress of Medical Physics 2015 10 - 12 December 2015, Yogyakarta, Indonesia
Secretariat of SEACOMP 2015: Jl. Ganesa 10, Lab. Biofisika, Fisika, FMIPA, ITB,
Email: [email protected] Website: http://www.medphys.fi.itb.ac.id/seacomp2015
APPLICATION FORM FOR THE SEAFOMP TRAVEL A WARDS
13th SEAOCM P, 10-12 December , 201 5, Yogyakarta, Indonesia
Completed applications each with a copy of the submitted abstracts must reach by
email: [email protected] on or before October 31, 2015
1. APPLICANT
Country of Practice:
Given Name:
Sure name:
Address at work:
Telephone No:
E-mail Address:
Present Job Position:
Main Duties:
Title of Paper/Poster:
(A copy of the submitted abstract must be attached to this application form)
Motivation for attending the conference (Attach a separate page if necessary):
Details of any SEAFOMP Awards Received Before:
Signature of Applicant:
Date:
13th South East Asia Congress of Medical Physics 2015 10 - 12 December 2015, Yogyakarta, Indonesia
Secretariat of SEACOMP 2015: Jl. Ganesa 10, Lab. Biofisika, Fisika, FMIPA, ITB,
Email: [email protected] Website: http://www.medphys.fi.itb.ac.id/seacomp2015
2. ENDORSEMENT OF APPLICATION BY SEAFOMP NATIONAL
MEMBER ORGANIZATION
Name of SEAFOMP Member Organization:
Name of Official:
Position in Organization:
Correspondence Address:
E-mail Address:
Comment on the Application:
Signature of Official:
Date: