68 Harden Bursary Form

68 Harden Conference bursary form

Application deadline: 8 June 2010

Travel bursaries and full or partly sponsored free places are available for graduate students and those who gained their PhD in the last 5 years. Preference will be given to senior graduate students and restricted to members of the Biochemical Society and relevant associated Societies. Please note that all Harden Bursary applicants must also apply to attend the conference. All Harden Bursary applicants will be informed approximately two weeks after the application deadline whether the application has been successful.

*Title:
*First name:
*Surname:
*Gender:	Male Female
*Age:
*Work address:
*Country:
*Postcode:
*Email address:
*Daytime phone no.:
Fax:
*Member status:
*Member no.:
*Date of joining:
*Post held:
What year you are in (for postgrad. res. students):
Other post held:
List your qualifications- date and where obtained
*First qualification:
*Second qualification:
*Third qualification:
Your referee's contact information
*First name:
*Surname/family name:
*Email:
Written reference:
*Meeting title:
*Accommodation cost £:
*Registration fee £:
*Travel from:
*Travel to:
*Total claim:
*Other sources to which you are applying for financial assistance and the amount you may receive?:
Method of payment:
For UK and foreign bank transfers: Account holder name:
Bank Sort Code:
Account no.:
For foreign transfers: Bank name:
Bank address:
SWIFT/BIC code:
IBAN Number: