Fundamental Research Workshop Grant Application

1. Workshop Title *This question is required.

2. Proposed Start Date of Workshop
*Must take place in 2027 *This question is required. This question requires a valid date format of DD/MM/YYYY.

calendar DD/MM/YYYY

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

calendar DD/MM/YYYY

4. Topic of Workshop: Describe the scientific focus of the workshop and how it relates to ISTH's mission of advancing understanding, prevention, diagnosis, and treatment of conditions related to thrombosis and hemostasis. Please limit to one paragraph. *This question is required.

5. Abstract and Description: Summarize the proposed workshop. Please limit to 3 paragraphs. *This question is required.

6. Relevance and Timeliness: Discuss why a scientific workshop on the proposed subject is needed at this time. Please limit to 2 paragraphs. *This question is required.

7. Relationship to Existing ISTH Projects, Workshops, and Meetings: What distinguishes this proposed workshop? Describe why this topic could not be incorporated into an already existing meeting or workshop. Comment on any relationship with or connections to ISTH programs or committees (such as the SSC, Education Committee, Reach-the-World Program, Fellowships, etc.) Explain which other funding is available and which costs will be covered by ISTH funding. Please limit to 3 paragraphs. *This question is required.

8. Budget and Other Funding: Please upload a spreadsheet or document outlining the budget for the proposed workshop which includes other funding sources and the amount committed. *This question is required.

File: {{filename}} delete

9. Proposed Chair *This question is required.

First and Last Name *This question is required.

Title

Street Address, Apt/Suite/Office *This question is required.

City, State, Postal Code *This question is required.

Country *This question is required.

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

Phone Number +

Short Biography
*Please limit to 1 paragraph, not to exceed 300 words *This question is required.

10. Please upload a CV for the proposed chair *This question is required.

File: {{filename}} delete

11. Proposed Co-Chair (if applicable)

First and Last Name

Title

Street Address, Apt/Suite/Office

City, State, Postal Code

Country

Email Address This question requires a valid email address.

Phone Number +

Short Biography
*Please limit to 1 paragraph, not to exceed 300 words

12. Please upload a CV for the proposed co-chair

File: {{filename}} delete

13. Proposed Vice Chair *This question is required.

First and Last Name *This question is required.

Title

Street Address, Apt/Suite/Office *This question is required.

City, State, Postal Code *This question is required.

Country *This question is required.

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

Phone Number +

Short Biography
*Please limit to 1 paragraph, not to exceed 300 words *This question is required.

14. Please upload a CV for the proposed vice chair *This question is required.

File: {{filename}} delete

15. Vice Chair Biographical Sketch: Provide a brief biographical sketch of no more than 4 paragraphs for the proposed vice chair(s) of the workshop. (Limit to 4 paragraphs) *This question is required.

16. Proposed Co-Vice Chair (if applicable)

First and Last Name

Title

Street Address, Apt/Suite/Office

City, State, Postal Code

Country

Email Address This question requires a valid email address.

Phone Number +

Short Biography
*Please limit to 1 paragraph, not to exceed 300 words

17. Please upload a CV for the proposed co-vice chair

File: {{filename}} delete

18. Co-Vice Chair Biographical Sketch: Provide a brief biographical sketch of no more than 4 paragraphs for the proposed co-vice chair(s) of the workshop. (Limit to 4 paragraphs) *This question is required.