SCHOLARSHIP APPLICATION - ICM BALI 2020

Lao Midwife Fund Scholarship Application
ICM 32nd Triennial Congress Bali, Indonesia 2020
Lao Midwife Fund is committed to providing international education opportunities to support the development of midwifery in Lao PDR. We believe that education is a key component in the advancement of women and children's health. Our scholarship program provides financial assistance to Lao Midwives and Lao Midwifery students who would otherwise be unable to cover the cost of attendance. Lao Midwife Fund is looking to provide financial assistance to a Lao Midwife or a Lao Midwifery student who is unable to cover the cost to attend ICM's 32nd Triennial Congress in Bali, Indonesia!

Scholarship Includes:

Economy airfare
Conference Registration Fee
Per Diem (days of the conference)
Accommodation
Ground Transportation
Health Insurance

We hope to find the following in our candidates:

Proficiency in spoken English
Is a midwife/midwifery teacher or midwifery student
Demonstration of financial need
Enthusiastic and social
Preference will be taken for those who are:

- Work with vulnerable populations
- Working to advance gender equality, and health, rights and wellbeing of girls and women
- Interest in supporting the development of midwifery in Lao PDR

Scholarship Requirements – upon acceptance, commitments:

Availability from approximately June 20-27, 2020
Participate in the conference: on-site attendance for the full duration (June 21-25, 2020) and post-conference activities (TBA)
Hold at least 2 post-conference events in community or demonstrate content usage from conference to midwifery in Lao PDR (within 5-6 months of return)
Written report to Lao Midwife Fund documenting post-conference events (due 2-3 months after event)

I have read the above and want to apply for the Lao Midwife Fund Scholarship to attend ICM's 32nd Triennial Congress *

Agree

APPLICATIONS ACCEPTED UNTIL DECEMBER 15, 2019 EST
Please fill in the fields below. It is important that your contact details are correct so that we can contact you.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Province *

Attapeu Province Bokèo Province Bolikhamxai Province Champasak Province Houaphan Province Khammouan Province Luang Namtha Province Louangphabang Province Oudômxai Province Phôngsali Province Salavan Province Savannakhét Province Vientiane Province Vientiane Prefecture Xaignabouli Province Xékong Province Xaisomboun Province Xiangkhouang Province

I am a: (choose all that apply) *

Midwifery Student Midwifery Educator Midwife New Midwife (less than 5 years) Other

What do you hope to gain from your attendance at the International Confederation of Midwives 32nd Triennial Congress? *

If selected, what type of activity or event do you hope to plan when you return home to share the information your learnt? *

Is there anything else you would like us to know about you for your application? *

References
References are people such as supervisors or teachers that know you the best and that can speak to your application. We will be contact only the references of those who are short-listed for the scholarship.
Could you provide us with a reference for your application? (They do not need to be fluent in English)

Name of Reference *

First

Last

Email of Reference *

Phone Number of Reference *

How does your reference know you? *

Submit

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