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CX 2017 Grant application 2017-03-31T13:22:38+00:00

CX 2017 Grant Application Form

This year, we are pleased to announce that BIBA Medical has a number of educational grants available to qualified physicians based in Germany to attend the Charing Cross Symposium 2017 at London’s Olympia.

Successful applicants will have the cost of registration and hotel paid for, as well as having travel costs reimbursed after the event.

To apply, please complete the online application form below. Successful applicants will be given a voucher code to register.

  • Requests will be reviewed by a Grants Review Panel
  • Please complete all sections as failure to do so could result in a rejection
  • The grant will cover full CX registration (access-all-areas), up to 3 hotel nights (single occupancy, including bed and breakfast and VAT), travel reimbursement (economy flight/train up to the value of £500).
  • Successful applicants must register using an online code no later than the 5th April
  • Travel must be booked by the individual and receipts sent to the CX team by the 10th April
  • Travel will not be reimbursed in the event of a no-show
  • We request that successful applicants complete a short feedback questionnaire during or after the event

Title (required):

First Name (required):

Surname/Family Name (required):

Institution (required):

Job title (required):

Speciality (required):

Other speciality:

Address details

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Address Line 2:

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County:

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Post code/Zip Code (required):

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Mobile/Cell number:

Have you ever attended CX before?
YesNo

If yes, how was your registration funded?
Self-fundedSupported by a companySupported by an institutionFacultyOther

Please let us know how you will benefit from attending CX:

Please let us know your main areas of interest at the event: