Admission to the ISSA

In order to apply to the ISSA 2014, applicants will have to send as attachment this application form filled in to the mail April15th, 2014.Admission to the ISSA (including non admission or admission on a reserve list) will be notified to applicants by e-mail by May 9th, 2014, when they will receive further information on payment of the registration fee, programme details and other logistic aspects.

Registration, fee and costs covered by the ISSA

Selected applicants will have to confirm their registration by sending an e-mail to , attaching a scanned copy of the registration fee payment of 400 Eurosby 6thJune, 2014, and specifying any personal needs for accommodation, travelling or meals (e.g. barrier-free environment, vegetarian or special diet). The fee includes: travel; accommodation for 5 nights; lunches, dinners and coffee breaks for 5 days; teaching material; the social event.

Travelling and accommodation

Please do not make any travel arrangements until your application has been accepted and further information concerning travel options are notified to you. Accommodation in Lund will be organised by Lund University for the length of the programme. Details on both travel and accommodation will be sent once the application is accepted and the fee is paid. Participants will be responsible for obtaining a visa to Sweden, if necessary. In case an invitation letter from Lund University is needed to this purpose, participants are recommended to request it as early as possible.

Cancellation Policy

Selected applicants can withdraw from the ISSA at no costs (i.e. will be fully reimbursed in case they already paid their registration fee) only until 6thJune, 2014. After this date, no reimbursement will be granted in case of withdrawal.

PART 1. PERSONAL INFORMATION

Last Name

First Name

Gender (M/F)

Date of birth (YYYY/MM/DD)

Place of birth (city/country)

Nationality

Personal address (street/number/ZIP code/city/country)

Telephone

(with international call prefix)

Mobile phone

(with international call prefix)

E-mail address

PART 2. EDUCATION AND RESEARCH INTERESTS

Academic degree
(e.g. M.Sc., M.D., Ph.D.)
Current affiliation
Current position (e.g. Ph.D. student, post-doc)
Name and e-mail of current academic supervisor
Research field (please mark disciplines with an “X”; you can eventually add notes for specifying sub-disciplines or branches) / 1) biomedicine
2) psychology
3) sociology
4) economics
5) demographics
6) medicine/geriatrics
7) epidemiology/statistics
8) technology and environment
9) other(s): please specify
Specific research interests
Previous positions in academy or research institutions
(if more, please write a list)
Other roles or commitments (e.g. member of editorial board, working group)
Main publications (max 10)
What are your motivations to attend the ISSA programme?
Did you ever attend any other summer school on ageing? If yes, which one(s)?

PART 3. LANGUAGE SKILLS

In order to participate to the ISSA, the candidate must have at least a good knowledgeof the English language. Please specify your level of English proficiency (basic, intermediate, good):

Speaking
Listening
Writing
Reading

If you speak any other language, please specify your proficiency below:

(language 1) / (proficiency: basic, intermediate, good)
(language 2) / (proficiency: basic, intermediate, good)

PART 4. INFORMATION FOR FUTURE EDITIONS OF THE ISSA

How did you get aware of the ISSA?
What are the communication channels you would recommend for promoting the ISSA programme?
(e.g. specific websites)

FINAL DECLARATION

I, the undersigned, hereby declare that information provided in this application form is truthful and accurate.

By signing this form the applicant authorises the processing of data contained in this form under Swedish national legislation (Personal Data Protection Law) for Lund University administration and promotion purposes only.

Date

Signature

1