IPSF Development Fund 2016-2017

Regional Event Grant Application - IPSF Regional Events 2017

Guidelines for Development Fund Applicants
Please read carefully before completing the application form
1. Background
The main goal of the Development Fund is to give each and every pharmacy student an equal opportunity to fully
participate in IPSF activities. This opportunity is also intended to help promote IPSF within their Schools of Pharmacy
and countries. The Development Fund was initially created with the aim of supporting students who were unable to
attend an IPSF event because of financial reasons. Currently the Development Fund may also be used to pay the IPSF
Annual Membership Fee of organizations from low or lower middle income countries (as defined by the World Bank)
and developing nations (as defined by the United Nations), to financially support IPSF activities undertaken by members
and participation in IPSF events and to award Student Exchange Program Grants.

This is the official application form for participation in the following IPSF events during 2017:

1. The 6th IPSF African Pharmaceutical Symposium, Kumasi, Ghana, 4th-10th July 2017
(http://www.afps2017.org/)

2. The 11th IPSF Pan American Regional Symposium, Ottawa, Canada, 2nd 8th July 2017
(https://www.facebook.com/parscanada2017/)

3. The 16th IPSF Asia-Pacific Pharmaceutical Symposium, Bangkok, Thailand, 21st 27th July 2017
(https://www.facebook.com/APPS2017Thailand/)

4. The 6th IPSF Eastern Mediterranean Pharmaceutical Symposium, Kuwait City, Kuwait, 14th 19th
of July 2017
(http://emps2017.com/)

Completing this application form means that you have decided to embrace this opportunity and play an active role in
IPSF, locally, nationally, and internationally. Congratulations!

However, it is essential that applicants understand this grant is given to a student to allow him/her promote IPSF in their
home country upon returning from an IPSF event not as a free holiday.

These guidelines were designed to ensure that potential applicants are fully aware of the selection process and also
accept the expectations, restrictions and consequences of an application.

The grant is awarded to attend the IPSF Regional Event as stated above and may cover part or full travel expenses
(bus, train or flight tickets) from the applicants home country to the event and/or the event registration fee up to a
maximum of 500 Euro. This round of event grants is solely for those attending the above regional events.
2. Completion of the application form
Please ensure the application form is completed accurately with any other information relevant to the selection process
being added to the form. Every section must be completed for the application form to be considered valid. Applicants
must submit an electronic version of the application form prior to the closing date (the 31st of March 2017 11:59pm
GMT+0) before any applications will be considered complete. The electronic version should be emailed directly to the
Development Fund Coordinator (df@ipsf.org).

3. Who is involved in the DF grant selection procedure?

3.1. The decision-making committee, who will consider valid applications, is the Development Fund Committee
which consists of three member representatives from three different countries, the IPSF Treasurer and the Development
Fund Coordinator, who chairs the committee.

This committee corresponds via email and discusses issues relating to the selection process and ways to optimize the
impact of the Development Fund grants at local and international levels.

Successful applicants will be notified by the Development Fund Coordinator before the 23rd of April 2017.

3.2. The applicant must be currently studying for their pharmacy undergraduate degree (first pharmacy degree) or a
recent graduate (within 4 years). An applicant may be an IPSF member through an IPSF Member Organization (Full
Member or Member in Association) or as an Individual Member. Selected or not, an applicant is expected to provide
accurate information and add any additional information that would be relevant in the consideration of the application
form.

If selected to receive the grant, a recipient is expected to:

Take an active part in IPSF activities and projects during and after the IPSF event attended.
If possible, deliver a presentation based on pharmacy practice and studies in their home country during the
IPSF event attended.
Produce a report addressed to the Development Fund Committee and to the IPSF Executive detailing a review
of the experience; what has been learnt and which IPSF projects/activities are planned to be implemented in
their country and why.
o This report must be sent no later than 1 month following the IPSF event attended.
Based on the report recipients may be required to write an article about pharmacy in their country and/or the
experience gained from attending the respective IPSF event, to be published in the IPSF News Bulletin, IPSF
Newsletter or on the IPSF website.
Keep in regular contact with the new IPSF Executive Committee after the congress to maintain correspondence
regarding what has been done in their country in order to maximize the impact and benefits the experience will
provide to other pharmacy students in that country.

4. Grant coverage and criteria

The awarded grant will cover only part of the expenses: either the event registration fee or the travel expenses (bus,
train or flight tickets and visa costs) up to a maximum of 500 Euro, but not both. In the event of the actual costs incurred
being less than the awarded grant then only the amount of actual costs will be paid.

The grant will be preferably paid by bank transfer after participating in the event and submitting the required
documents. In special cases the grant may also be paid to the recipient at the event by cash.

The total number of grants awarded will be decided after the deadline for receipt of applications and will be dependent
on the total number of quality applications received and on the grant budget available.
Priority will be given to:
i. Applicants from low and lower middle income countries (as defined by the World Bank) or from developing
countries (as defined by the United Nations);
ii. Those who have served IPSF as a Contact Person, Student Exchange Officer, subcommittee member or in
some other way contributed to IPSF Projects;
iii. Students in their last year of study;
iv. Those who will be attending an IPSF event for the first time and/or are the only representatives from their
countries.

Special attention will be given to expenses of the trip and how reasonable they are, motivation letter and if other sponsors
were approached.

5. Issues to be taken in the consideration

5.1. Visas: It is essential applicants establish whether they require a visa to attend the respective IPSF event and begin
the necessary steps in order to be ready to apply quickly, in the event that the application is successful and a grant is
awarded.

No grant will be given to an applicant who fails to obtain the visa(s) required traveling to the country where the
IPSF event will occur.

Sadly, this issue often prevents recipients from actually attending the IPSF event. So please, be prepared if a visa is
required and collect any relevant documentation and information needed for a visa request in advance to accelerate
the procedure within the Embassy.

5.2. Sponsors: Applicants should look for sponsorship as soon as they start thinking of going to the IPSF event.
National, local and private bodies often have a budget to support students with these kinds of initiatives. The
Development Fund exists to help but rarely gives a grant that covers all of the expenses involved. It is advised
that initial steps with potential sponsors are begun immediately as it often takes a long time period before an answer
is received - one might even be surprised and obtain more sponsorship than was originally thought!

6. Situations and Consequences

To avoid any misunderstanding of the procedure, misuse of the grant or reduction in the grants awarded each year, this
section has been added to dissuade any potential applicant from hiding any relevant information or from providing
incomplete or false information on their application form.

It is an applicants responsibility to inform the Development Fund Coordinator of any changes in the information stated
in the application form as soon as the applicant is aware of any new information. It is recommended that all applicants
retain a copy of their application form to remember what has been stated in the application. If any changes of
circumstances occur after submitting the application form please inform the Development Fund Coordinator as soon as
possible. Any applicant awarded a DF grant and later found to have misused funds will not be eligible to receive any
DF Grant in the future. If the grant has been paid before the misuse has been identified then the applicant must pay the
grant fully or partly back to the IPSF Development Fund as determined by the Development Fund Committee and IPSF
Executive.
The Development Fund Committee reserves the right to withdraw or reduce any grant given to an applicant in
the event of any of the following situations arising:

Information relevant to the selection process was hidden from the Development Fund Committee by the
applicant.
Information stated by the applicant is later identified as being inaccurate or false and the applicant failed to
notify the Development Fund Committee about the necessary changes required to the application.
New information concerning the financial situation of the applicant (and the relevant member association,
when applicable) was not provided (such as a new sponsor, more money available than was originally
stated, bigger amount of funds allocated by the association to send the applicant to attend the event etc.).
Failure to submit the required documentation and/or receipts or submission of incomplete documentation.
Other situations at the discretion of the Development Fund Committee.
 IPSF Development Fund Regional Event Grant: Application form 2017

Every Section of this application form must be completed in order to be valid. An application will only be considered if
sections A, B, C and D have been completed, and the declarations electronically signed by inserting the relevant name.

Please complete the application form as a Microsoft Word Document and return this electronically via email to the
Development Fund Coordinator at df@ipsf.org before the 31st of March 2017 11:59pm GMT+0. When returning your
application, please rename the file to include the event you wish to attend and your name, for example: DF [Regional
Event] 2017 - Name

SECTION A
PERSONAL DETAILS

Full Name Mr / Mrs / Miss

Full Address

Country

Nationality

Telephone Number

Fax Number

Email

Current Passport Number

Valid until:

Visa Requirements
Cost of Visa (Euros)
Time Required To Obtain Visa

Contact Information of relevant

embassy in your country

Contact person in the embassy you

have spoken to and title
STUDY DETAILS

Name of School of Pharmacy at

which you are studying

Address

Qualification you will receive

Total length of course

Date of graduation (expected)

INVOLVEMENT WITHIN YOUR NATIONAL ASSOCIATION AND WITHIN IPSF

(Maximum 400 Words)

Word
Count
FINANCIAL DETAILS

Your National Currency

Exchange rate on 1 Euro ()

Exchange rate on 1 Euro () [TREASURER TO COMPLETE]

Verified by Treasurer on 31st March 2017

Yearly Income (received during the previous 12 months)

Income Type National Currency Euro

Applicants Income
Scholarship/Grant Money
Loans, please specify
student or other

Fathers Income
Mothers Income
Family Allowance (money from family for
expenses)
Other sources of
income, please specify

TOTAL

Yearly Expenditure (spent during the previous 12 months)

Income Type National Currency Euro

Rent or housing
Electricity, gas, water
Phone & Internet

Food & Groceries

Tuition
Books, stationary, school supplies
Clothing, shoes, personal hygiene
Other sources of
expenditure, please
specify

TOTAL
(Living expenses are considered as necessary costs for living that are paid by the applicant personally. For example food, accommodation expenses
(flat rent), electricity fees and study costs (books etc.) but not unnecessary costs like holidays)
 Estimated travel and National Currency Euro
visa expenses to attend
the IPSF event (state for
return journey)

(Please complete the below table as appropriate detailing your estimated travel route and the corresponding costs.
Please note that only one row will need to be completed for a direct travel option. However for a travel plan which
involves a number of modes of transport each leg of the journey should be listed on a separate row. For example: Row
1: Flight Amsterdam, The Netherland to Cairo, Egypt; Row 2: Bus Cairo, Egypt to Hurghada, Egypt etc.)

Destination(each leg Estimated Costs Route and means of Source of the information
of the journey on a (including return Transportation (Website/travel agency etc)
separate row) travel) If you have an electronic
document please attach it
SPONSORSHIP DETAILS
State the names of any bodies in your country which you have already contacted for sponsorship, when you contacted
them and the actual or possible results of the request (s):

SPONSOR CONTACT DATE RESULT

IPSF can give advice about approaching sponsors in your home country. Applicants are expected to try and find
sponsorship from other bodies apart from the IPSF Development Fund, and to explain why if this has not been done.
SECTION B
MOTIVATION
In this section applicants should detail their reasons for applying for the grant; specifically their reasons for
attending the respective IPSF event, and also describe how attendance at such an event would benefit other
pharmacy students in their home country. Please also state any additional information that may be relevant to
the selection process, especially details relevant to the Priority criteria stated in section 5.

As this section is seriously considered during the selection process, applicants are reminded of the importance of stating
clear and realistic reasons for their participation, with a focus on the personal, national and international impact an IPSF
event experience may create. The length of this motivation should be no longer than 400 words.

Word
Count
SECTION C
STUDENT ASSOCIATION DETAILS
(To be completed by the President and Contact Person)

Name of your National Association

Address of your association

Name of the IPSF Contact Person

Can this association contribute to your Yes No

expenses
If yes, how much?

Are you an official delegate? Yes No

Are any other persons (graduated, Yes No

student, others) from your country
attending? If yes, are they,
a) Students from your Yes No
local student
association
b) Members of your Yes No
national association

Names and positions of attending Name Position

persons

(Please insert more rows or attach an

additional page if more students are
attending)
For the application to be valid, the most recent audited balance sheet of the association must be
submitted with the application.

We declare that:

1. The information stated above in Section C is to the best of our knowledge complete and accurate.
2. In the event of any changes in the information stated above, we will notify the Development Fund Coordinator, without
delay to prevent the potential withdrawal of the grant (if the application is successful).

LOCAL STUDENT ASSOCIATIONS PRESIDENT

Signature

Name

Date

Email Address

NATIONAL PHARMACY STUDENTS ASSOCIATIONS PRESIDENT

Signature

Name

Date

Email Address

IPSF CONTACT PERSON

Signature

Name

Date

Email Address
SECTION D
LETTER OF SUPPORT FROM SCHOOL OF PHARMACY
To be completed by the Head of School or Dean of the Department of Pharmacy at which the applicant is studying. The
Head of School or Dean should confirm that the statements made by the applicant in Sections A and B of this form are
complete and accurate therefore they must have seen a copy of the completed application form. The letter of support
should be attached as a separate Word Document.

SECTION E
DECLARATION
I declare that:
1. I have read the guidelines and both understand their meaning and respect them.
2. I accept the consequences undertaken by the Development Fund Committee if I fail to respect these rules
3. The information stated is to the best of my knowledge, complete and accurate.
4. I will notify the Development Fund Coordinator of any changes in the information stated above without delay by
email at df@ipsf.org.
5. I will make every effort to stimulate active interest in IPSF within my country.
6. I accept the fact that, in the case of my application being successful, the Development Fund Committee reserve
the right to withdraw the grant if any of the situations stated in the section Situations and consequences of the
above guidelines occurs.
7. If this application is successful, I will respect the duties of the applicant stated in the guidelines written at the
beginning of the application form (as per Section 4.2.)

APPLICANT

Signature

Name

Date