Clinical Immunology Fund- Application Form

This charitable fund established by Associate Professors Desa Lilic and Mario Abinun is to promote links between Newcastle UK and Serbia in the field of immunology.

If you have any informal queries or technical issues submitting your application form, please email elaine.stephenson3@ncl.ac.uk.

Name of applicant First Last
Nationality of applicant
Contact email for applicant
Contact phone number for applicant - ### - ### ####
Home organisation and department of applicant
Contact address for applicant
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of host organisation and specific department

Applicants should have an agreement in principle with a host organisation based in the alternate location, either Newcastle, UK or Serbia
Named contact at host organisation
Job title / position of named contact
Proposal start date / MM / DD YYYY
Proposal finish date / MM / DD YYYY
Funding requested please give amount in GBP (maximum £3000GBP) £ . Pounds Pence
Please submit details of your proposal (max 1000 words).
This must include clearly defined aims, objectives and outcome measures. *
Maximum of 1000 words allowed. Currently Entered: 0 words.
Please submit details of your proposal's anticipated impact for the field of clinical immunology (maximum 200 words).
Maximum of 200 words allowed. Currently Entered: 0 words.
Please provide a detailed justification for the funds requested (maximum 500 words).
Maximum of 500 words allowed. Currently Entered: 0 words.
CV of applicant

Attach Files Attach Files
Letter of support from applicant's HOME institution

Attach Files Attach Files
Letter of support from applicant's HOST institution

Attach Files Attach Files
Data Protection Statement

Data provided in this form will be used by the administration team for this fund. It will be shared with the selection panel in order to consider your application.

Clinical Immunology Fund- Application Form

Clinical Immunology Fund- Application Form

Data Protection Statement