VT Educational Grant Application

APPLICATION FOR EDUCATIONAL GRANT FUNDING FROM THE VESALIUS TRUST FOR VISUAL COMMUNICATION IN THE HEALTH SCIENCES

 

NAME OF GROUP REQUESTING FUNDING ______________________________________

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NAME AND TITLE OF GROUP REPRESENTATIVE ________________________________

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ADDRESS TO WHICH RESPONSE SHOULD BE MAILED __________________________

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DAYTIME TELEPHONE FOR INQUIRIES ________________________________________

TITLE OF EDUCATIONAL PROJECT / PRESENTATION ____________________________

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NAME (S) OF PRESENTER (S) __________________________________________________

FORMAT OF PRESENTATION __________________________________________________

WILL CONTINUING EDUCATION UNITS BE GIVEN TO PARTICIPANTS? ___________

 

*** PLEASE ATTACH THE FOLLOWING APPLICABLE ITEMS ***
  1. A description of how the research / presentation will be conducted.
  2. A list of the educational goals of the research / presentation in terms of the individual reader’s / attendee’s accomplishments.
  3. A rationale describing the value of such a research / presentation to the profession represented by your group.
  4. A brief biography of all research / presenters, detailing their expertise in the area of this presentation.
  5. A detailed budget of all expenses to be covered by the grant.

TO BE CONSIDERED FOR FUNDING, COMPLETED APPLICATIONS MUST BE RECEIVED NO LATER THAN DECEMBER 31st TO BE CONSIDERED FOR FUNDING IN THE NEXT CALENDAR YEAR.

Mail completed form to: Vesalius Trust

20751 West Chartwell Drive

Kildeer, IL 60047