EDUMAD Application form

There is no deadline for the application. A total of 10 fellowships are available. Applications will be accepted until all fellowships are assigned.

Application Details
1. I would like to apply for the following fellowship:
2. Select a fellowship
3. Additional information - specify according to your choice above
4. Specify course (multiple possible)
  1. Laboratory Systems and Public Health in Resource-Limited Settings (LAB-SPHERE)
  2. Epidemiology & Control of Infectious Diseases in Outbreak Settings (EPICID)
5. Specify conference link
Personal Data
1. Please provide the following information about yourself.
2. Title *
3. First Name *
4. Surname *
5. Date of birth (DD-MM-YYYY) *
6. Sex *
7. Country of residence *
8. Nationality *
9. Current home address (Street, Post Box, ZIP Code, City, Country) *
10. Phone (+ country code) *
11. Email *
Professional background
1. Please provide the following information about your professional background.
2. Name of current employer/institution *
3. Faculty, Department
4. Your job position (e.g. clinician, researcher/lecturer) *
5. Address of Employer/Institution (Street, Post Box, ZIP Code, City, Country) *
Education
1. Please provide information about your academic degrees - in chronological order.
2. Degree 1 *
3. Field of study *
4. Name of institution *
5. Duration of study (MM/YY-MM/YY) *
6. Degree 2 *
7. Field of study
8. Name of institution
9. Duration of study (MM/YY-MM/YY)
10. Degree 3 *
11. Field of study
12. Name of institution
13. Duration of study (MM/YY-MM/YY)
English language skills
1. These short courses are held in English. Therefore, participants have to be proficient in spoken and written English.
2. Please indicate your level of English language proficiency: *
General Computer Skills
1. General computer skills are crucial to follow these courses.
2. Please indicate your level of general computer proficiency: *
Statement of Motivation
1. Please provide a brief statement (max. 300 words) outlining why you would like to attend this course and what benefits you hope to gain from participating in it.
2. Your statement... *
Additional comments
1. Any other information you wish to communicate to the organisers?
2. Comments
1. I have read and understood the privacy statement *
2. You will find the privacy statement here.
3. Please note if you have been offered a place on the course you will be asked to provide proof of your highest academic degree and you will be required to bring formal ID. If you are a tropEd student, you will also be required to provide a copy of your MScIH admission letter from your home institution and proof that you are currently enrolled in the MSc in International Health Programme (copy of your student ID or letter from your home institution).
* These fields are required
Send Application Form
1. Click the button to submit

Kontakt

Daniela Fusco, MSc, PhD

Project manager

+49 (0)40428 18-243

E-Mail: fusco@bnitm.de

Paule Donven

Secretary in Germany

E-Mail: edumad@bnitm.de

Toninjanahary Florentine

Secretary in Madagascar

E-Mail: edumad2021@gmail.com