Request for ISE Support
Please duly complete the form below to request ISE support for your activity. Requests for support MUST be submitted on behalf of an ISE member in good standing. Requests for program development and/or financial support must be submitted at least 9 months in advance of the meeting.
Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Phone Number
*
-
Country Code
Phone Number
I am submitting on behalf of the following organisation (ISE member in good standing)
*
I would like to request ISE support for the following activity
*
Event Start Date (if available)
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Month
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Day
Year
Date
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Event End Date (if available)
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Month
-
Day
Year
Date
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What is the main language of the event?
*
I have approached other organisations to request support/endorsement
Yes
No
If Yes please specify which organisations you have approached
Expected number of participants
*
What is the purpose of the event?
*
What is the target audience of the event?
*
What are the topics covered?
*
How do you expect the event to impact on the field of endocrinology in your country and region?
*
Please describe the measures you will take to encourage the attendance of the younger and/or less advantaged colleagues from your region (eg: reduced rates, travel grants, early career awards)
*
What type of support are you requesting from ISE?
*
Level 1 - Promotion of the event through ISE communication channels
Level 2 - Support with program development
Level 3 - Financial support for international speakers
Level 3 - Other financial support
Please describe your needs for program development
eg: Help and advice in establishing a suitable scientific program developed to meet the precise needs of the local/regional endocrine communities; Advice in selecting expert speakers in relation to the scientific program;
Please describe what international speakers you would like to approach, in which field and why you need ISE financial assistance
Funding travel of a maximum of three sponsored speakers
Please describe the other financial support needed
Please upload a copy of your (draft) event program
*
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Please upload a copy of the financial projection and breakdown of your event
*
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Upload any other document (promotional, event outline ...)
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