2016-17 BAYER RESEARCH & TRAVEL GRANT
FUND FOR VECTOR CONTROL RESEARCH
Please confirm that you meet the criteria for this funding by
ticking the relevant check boxes below before completing the
application form.
☐ I am a registered London-based MSc student at LSHTM
in the 2016-17 academic year
☐ I confirm that my MSc project will be lab- or field-based (not a paper review)
☐ I enclose my project outline (no more than 2 A4 sides) which includes: background/introduction and rationale, aims and objectives, method details.
Please note that your application will not be processed further if you have not fulfilled these criteria.
Student Reference Number / MSc CourseFamily Name or Surname / First Name/s
Contact Address
Contact Telephone No. / Contact Email Address
Title of Project
Project Location
Proposed Project Dates
From: To:
Please provide justification for requiring this extra funding (above ITD bench fees).
Declaration
I certify that, to the best of my knowledge, the statements made by me on this form are correct and complete.
If I am successful in gaining a scholarship
ü I agree to write a formal letter of thanks to the funder, if asked to do so
ü I agree to acknowledge the funding in my project report
ü I give consent for my name and the award to be announced in LSHTM publications and on the internet and for photographs of me taken at School events to be used in future promotional materials. I also consent to write a 250 word student profile for use in LSHTM publications
Signature______Date ______
Typed signatures will not be accepted. Please sign by hand or use an electronic signature.
Please return by email to: , or in person to: Registry, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT by the scholarship deadline.