SRF Bursary for Fertility 2024

Your Contact Details

Prefix

First name *

Surname *

Email Address *

Please confirm your email Address *

Title (Dr. Associate Professor, Professor etc) *

Organisation *

Organisation Address

City

State/Province

Zip/Postal

Country

Contact Number

BURSARY PART 1 – REGISTRATION REQUIREMENTS

Please indicate the type of registration you will require for Fertility 2024.

Please indicate the type of registration you will require for Fertility 2024 *

Full Conference Member Registration

Undergraduate Student Member Registration**

Council Member

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

Will you be attending the SRF Social Event on the evening of Wednesday 10 January? *

Yes

No

Would you like a ticket to the Conference Dinner on the evening of Friday 12 January? *

Yes

No

Are you willing to be contacted by the conference sponsors and exhibitors?

Yes

No

Are you willing to be sent information on other, relevant conferences?

Yes

No

Are you willing to consent to your name, job title and place of work to be included on the delegate list?

Yes

No

Do you have any accessibility requirements?

Yes

No

Please give details on any extra support you may need.

Do you have any special dietary requirements?

If you selected other, please advise:

Have you attended a Fertility Conference before?

Yes

No

If yes, how many?

SRF Membership Type

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 2022 and 2023) 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 2023 membership. PLEASE NOTE THAT MEMBERSHIP PAYMENTS MUST BE PAID BEFORE APPLICATION

SRF Membership Category *

Please enter your SRF Membership ID *

*If you are an Early Career Undergraduate, Masters or PhD student and have paid for 2023 membership please confirm your membership status below. Please provide the details of your Supervisor below, the SRF will automatically contact your Supervisor to verify your status.

I have paid for my 2023 membership

I am an Early Career Undergraduate, Masters or PhD member

Supervisor’s Title (Prof/Dr etc.)

Supervisor’s Surname

Supervisor’s Email Address

BURSARY PART 2 – ACCOMMODATION

We advise that all reservations for travel and accommodation are refundable should the conference move to a virtual event. 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 do not live in Edinburgh and will require a bursary of up to £50 per night – maximum of £150 – for the following number of nights:

1 night

2 nights

3 nights

I am an Associate Editor for Reproduction and understand that I will receive 2 nights accommodation

Council Member

BURSARY PART 3 – TRAVEL

Please confirm one of the below

I live within 30km of the EICC, Edinburgh and understand that I am not entitled to accommodation

I am a UK or Irish resident and understand that I will receive up to £100 towards my travel

I am not a UK or Irish resident and will complete the section below

Council Member

Town/City of your permanent residence

For non-UK and Irish members, travel support is offered on a fixed band system based on the distance from the town/city of your work to Belfast and will be calculated using https://www.gps-coordinates.net/distance or similar (you will need to copy and paste this link into your browser) please enter the distance below in km.

Visa – Will you require a visa to travel to Fertility 2024?

Yes

No

Abstract confirmation

I have not submitted an abstract.

I have submitted an abstract and confirm that I will advise SRF Secretariat on the outcome of my abstract submission.

Council Member

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 https://srf-reproduction.org/grants-awards/grants/bursary-for-fertility/

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Your Contact Details

BURSARY PART 1 – REGISTRATION REQUIREMENTS

SRF Membership Type

BURSARY PART 2 – ACCOMMODATION

BURSARY PART 3 – TRAVEL

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