/ The Hong Kong Continence Society Limited
C/O Victor Ling Secretaries Limited
12/F, Hing Lung Commercial Building, 68-74 Bonham Strand, Hong Kong
Website:

Sponsorship Application for

Annual Meeting of the International Continence Society 2017

(Florence, Italy 12th - 15th September 2017)

The Hong Kong Continence Society will sponsor maximum 5members to attend the captioned meeting. Each sponsor will be HK$12,000 for passive participation orHK$15,000 for active participation (i.e. having a paper accepted for presentation). The paper submitted to ICS would be required to be presented in ASM 2017 of HKCS.

The application is now opened to all memberswith at least 2 recent consecutive years of membership (i.e. 2016 & 2017 memberships). If you are interested to attend the meeting, you are welcome to apply for the sponsorship by filling in the application form and e-mail to Ms. Amy Lauat or mailto the following address:

Ms. Amy Lau Lai Sin

Honorary Secretary, theHong Kong Continence Society Limited

APN

General Out-patient Clinic

Tung Wah Hospital

G/F Hawkin Wing

12 Po Yan Street

Sheung Wan

H.K.

Deadline of application:16 June 2017.

Selection Criteria for Sponsorship:
  1. Applicant must be current member of the societywith at least 2 recent consecutive years of membership (i.e. 2016 & 2017 memberships).
  2. Seniority of membership (number of years as HKCS member).
  3. Participation in the conference (e.g. paper presentation, moderator, etc.)
  4. Contribution to the Hong Kong Continence Society.
  5. Relevance of the professional expertise of the applicant.
  6. Contribution to continence care in Hong Kong.

The sponsorship isnormally reimbursed to the successful applicants after the meeting with the provision of Attendance Certificate. Successful applicants cannot accept other source of sponsorship for the same meeting. Successful applicants who are HA staff should approach their cluster HRD for the HA rules & regulations on accepting external sponsor.

/ The Hong Kong Continence Society Limited
C/O Victor Ling Secretaries Limited
12/F, Hing Lung Commercial Building, 68-74 Bonham Strand, Hong Kong
Website:

Application Form forSponsorship to Attend the ICSAnnual Meeting2017

Title of the conference: Annual Meeting of the International Continence Society 2017 .

Organizing Institution: International Continence Society .

Date: 12th - 15th September 2017 Venue: Florence, Italy .

Title (e.g. Dr,Ms,Mr, Md):
Name(English): / (Chinese):
Organization:
Department: / Position:
Correspondent Address :
Telephone (Home): / (Office): / (Fax): / Pager/Mobile phone:
E-mail:
Number of years of HKCS membership (will be double checked by HKCS):
Contribution to the Hong Kong Continence Society (e.g. teaching, presentation, council member, meeting worker, etc.):
Yes No
Nature of contribution:
Participation in the ICS Annual Meeting 2017:
Presentation:
Oral / Poster /  Passiveattendance / Other : ______(please specify)
Contribution to Continence Care in Hong Kong (if any):

Remark: Put  in the appropriate box

Signature: ______Date: ______

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