Conference Travel Bursary

REQUIRED

Name of Applicant:*

REQUIRED

Home Address:*

REQUIRED

Telephone Number:*

REQUIRED

Email Address:*

REQUIRED

Please check all that apply:

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REQUIRED

Please provide the name of your educational institution, place of employment, or place of volunteer

REQUIRED

Please select one:

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REQUIRED

How will attending BCMA 2018 help you in your current studies or work?*

REQUIRED

Please indicate any and all other confirmed bursaries or financial assistance you will receive to participate at BCMA Conference 2018 (including support from your workplace)

REQUIRED

I confirm that the information provided above is true. I agree to respect the conditions and rules of the Bursary program of the BCMA and the decision of the Professional Development Committee. I understand that the Travel Assistance Bursaries will be paid to successful applicants upon confirmation of registration. Please note: If applicants are unable to attend conference, they will be required to return the bursary.

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