Supported Education Course Application

We welcome applicants from any country or region who can demonstrate a need, clearly define objectives and organize an educational activity that will benefit not just the course's participants, but the fields of thrombosis and haemostasis as a whole.

To access a detailed guide for supported course applications and the full requirements for supported courses click here.

Any national or regional Society and/or individual member of the ISTH can submit an application for organizing an ISTH-sponsored educational meeting. The person in charge should be an experienced physician or scientist in the discipline of Thrombosis and Hemostasis and ideally a proven educator. Previous experience with the organization of educational courses or scientific meetings will be a requirement. This person should be supported by a regional or national society.

All applications must be submitted at least 12 months before the proposed courses should take place. Members of the Education Committee may be consulted before an application is officially submitted but no commitment from ISTH can be made unless all details are provided. The Education Committee will review the applications within a 1 month's period from receipt of application where additional questions may be asked of the applicant. Applicants will be notified with a final decision after the 1-month period.

Organizer Information

1.

First Name *This question is required.

Surname *This question is required.

Institution *This question is required.

Department *This question is required.

Street Address *This question is required.

City *This question is required.

State/Region *This question is required.

Postal Code *This question is required.

Country *This question is required.

Work Phone

Mobile Phone *This question is required.

Email Address *This question is required. This question requires a valid email address.

Personal Statement

2. Provide a statement of motivation on why you would like to organize the course: *This question is required.

Educational Course Overview

3.

Course Title *This question is required.

Start Date *This question is required. This question requires a valid date format of DD/MM/YYYY.

MM/DD/YYYY calendar

End Date *This question is required. This question requires a valid date format of DD/MM/YYYY.

MM/DD/YYYY calendar

Name of collaborating Society/Institutions (if any)

Organizing Team Members (if applicable)

Proposed Location *This question is required.

Proposed Venue *This question is required.

Expected Number of Attendees *This question is required.

Target Audience/Regions Covered *This question is required.

Target Audience Description *This question is required.

How many sessions will the course have featuring evidence-based guidance or guidelines? *This question is required.

Course Description

4.

Provide a short description of the meeting content and objectives of the course: *This question is required.

Provide a short description of how the course will impact the target audience: *This question is required.

Education Course Topics

5. Proposed Topics

List your proposed topics here: *This question is required.

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6. Please attach a proposed program outline here *This question is required.

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Educational Course Speakers
Please provide proposed faculty (national, regional, international) and indicate those you would ideally like to have supported by ISTH:

7.

National/Regional Speakers

International Speakers

Budget
Please provide a detailed listing of income and expenses for the proposed meeting.

8.

Expenses

Space Cell	Cost	Total
Venue Rental	Venue Rental: Cost	Venue Rental: Total
Food/Beverage	Food/Beverage: Cost	Food/Beverage: Total
Speaker Travel	Speaker Travel: Cost	Speaker Travel: Total
Accommodation	Accommodation: Cost	Accommodation: Total
Audio/Visual	Audio/Visual: Cost	Audio/Visual: Total
Social Events	Social Events: Cost	Social Events: Total
Meeting Materials	Meeting Materials: Cost	Meeting Materials: Total
Promotional Material	Promotional Material: Cost	Promotional Material: Total

Other (please specify)

Income

Space Cell	Cost (per person)	Total
Registration Fees	Registration Fees: Cost (per person)	Registration Fees: Total
Local Institution/Society Grant	Local Institution/Society Grant: Cost (per person)	Local Institution/Society Grant: Total
Industry Support	Industry Support: Cost (per person)	Industry Support: Total
Other Income Sources	Other Income Sources: Cost (per person)	Other Income Sources: Total
Requested ISTH Support	Requested ISTH Support: Cost (per person)	Requested ISTH Support: Total

Other (please specify)

9. Please upload your complete budget spreadsheet here: *This question is required.

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