IOCCG Platt Scholarship Application Form

"*" indicates required fields

Applicant Details

YYYY/MM/DD
Gender

You may provide another email address where we can contact you
The name of the city where you currently reside
The name of the country where you currently reside

Current Professional / Academic Affiliation

Name of the University/Institute where you are currently studying/working.
List your highest degree attained along with the name of the University and the year you graduated, or expect to graduate if currently enrolled (e.g. PhD, Rome University, 2025).
Your current position (e.g. student, researcher, post-doc etc.) or the degree you are currently doing.
Your current area of research
Please upload a brief curriculum vitae (1-2 pages max., I MB max.) summarizing your professional and research experience and interests. Save your CV using the format: Lastname-Firstname-Platt-Scholarship-CV.pdf. Please do NOT include photographs or certificates etc.
Accepted file types: pdf, Max. file size: 2 MB.

Supervisor at Parent Institution

Please attach signed Letter of Recommendation from your own Supervisor. Save this letter using the format: YourLastname-SupervisorLastname-recommendation.pdf.
Accepted file types: pdf, Max. file size: 2 MB.

Supervisor at Host Institution

Please attach signed Letter of Recommendation from your host Supervisor. Save this letter using the format: YourLastname-HostSupervisorLastname-recommendation.pdf.
Accepted file types: pdf, Max. file size: 2 MB.

Proposed Research/Training

An estimate of the start date for the proposed training/research at host institute
YYYY slash MM slash DD
An estimate of the end date for the proposed training/research at host institute
YYYY slash MM slash DD
Attach a document with specific details of all aspects of training /research to be carried out at the host institution (2 pages max.) Include a detailed budget of anticipated expenses, specifying the currency, (e.g., return flight, visa, travel/health insurance, accommodation, food and incidentals). If the visit is estimated to costs more than USD $5,000, please indicate how the additional expenses will be covered (e.g., by host institute, own institute, other grants etc.). Save file using format: Yourlastname-firstname-Platt-Scholarship-description.pdf.
Accepted file types: pdf, Max. file size: 2 MB.
Relevance of the proposed training/research to programmes/research at your own institution and how training/research will contribute to capacity building at your own institution.
Please provide a brief personal statement (one to two paragraphs) outlining your goals, experience, attributes, and academic achievements, and how they relate to the proposed research/training. You may also demonstrate how this relates to any of Trevor Platt’s research.
Certify*
I certify that all the information in this form is true and correct at the time of writing.
This field is for validation purposes and should be left unchanged.

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