Fertility 2020 – Bursary Application Form | Society for Reproduction and Fertility

SRF Membership

All Full, Retired*, Honorary* and Early Career (EC)** Members who have been SRF Members for at least 2 membership years (i.e. must have paid for membership in 2020 and 2021) are eligible to apply. *These members are exempt from membership payment. ** The requirement for the 2 membership years will be waived for EC Members who are undergraduate, Masters or PhD students irrespective of year of study providing they have paid for 2021 membership.

SRF Membership Category *

Notes to 'Journal Associate Editors' for completing the rest of the form:

*If you are an Early Career Undergraduate, Masters or PhD student and have paid for 2021 membership please confirm your membership status below and provide the details of your Supervisor. The SRF will automatically contact your Supervisor to verify your status.

I have paid for my 2021 membership

I am an Early Career Undergraduate, Masters or PhD member

Supervisor's Title (Prof/Dr etc.) *

Supervisor's Surname *

Supervisor's Email Address *

Please enter your SRF Membership ID:

Your Contact Details

Title *

First name *

Surname *

Email Address *

BURSARY PART 1 - REGISTRATION REQUIREMENTS

Please indicate the type of registration you will require for Fertility 2022.

Please indicate the type of registration you will require for Fertility 2022 *

Full Conference Member Registration

One Day Member Registration

Student Member Registration**

**Student Member Registration applies to undergraduate, unsalaried students ONLY. The rate entitles Students to attend the full conference.

If you plan to book a 'one-day' registration, please indicate the day(s) you will attend. If you are planning to attend all days you should select Full Conference Member Registration or Student Member Registration from the options above. *

Wednesday 5 January

Thursday 6 January

Friday 7 January

Saturday 8 January

Will you be attending the Conference Dinner on the evening of Friday 10 January? *

Yes

No

BURSARY PART 2 - ACCOMMODATION

Due to the current COVID pandemic please ensure that all reservations you make for travel and accommodation can be cancelled and refundable. The SRF will not cover any accommodation or travel costs if the full physical attendance meeting is cancelled.

I confirm that I am fully responsible for any accommodation and travel costs I incur if the physical conference is cancelled. *

Please tick to confirm

I live in Liverpool and understand that I am not entitled to accommodation

Please tick if appropriate

I do not live in Liverpool and will require a bursary of £50 per night - maximum of £150 - for the following number of nights:

1 night

2 nights

3 nights

BURSARY PART 3 - TRAVEL

Travel support is offered on a fixed band system on distance from your place of work and will be calculated as follows: <10 km: £0; 10 - 100 km: £30; 100 - 300 km: £75; 300 - 500 km: £150; 500 - 750 km: £200; 750 - 1000 km: £300; >1000 km: £400

Work address

Town/City

Postcode/Zipcode

County/State

Country

Visa - Will you require a visa to travel to Fertility 2022? *

Yes

No

PLEASE NOTE: funds for travel will only be paid once the Secretariat has received confirmation from you that your visa application has been successful

Disclaimer *

I confirm that I have read and understood the terms and conditions relating to the award of a Fertility bursary as detailed on the SRF website http://srfnew.wpengine.com/grants-awards/terms-and-conditions/.

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Fertility 2020 – Bursary Application Form

SRF FERTILITY 2022 Bursary Application Form

SRF Membership

Your Contact Details

BURSARY PART 1 - REGISTRATION REQUIREMENTS

BURSARY PART 2 - ACCOMMODATION

BURSARY PART 3 - TRAVEL

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