Application form reduced fees

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Reduced FEES for 2015 courses
REDUCED fees for participants from less competitive economic
backgrounds
ESTRO members working in countries with a less competitive economic background can obtain a reduced
participation fee of 350€ to attend live teaching courses organized in Europe.
This reduced fee at 350€ will be granted to 500 participants per year. It replaces the special fees given
to participants from Central or Eastern European countries for courses held in Central and Eastern Europe
only.
Selection Criteria*
1. Only ESTRO members for 2015are eligible (hereunder the list of eligible countries)
2. Only one course per person per year can be subsidized
3. Max 250 participants can register at the reduced fee in the first semester of 2015 and another 250 in the
second semester of 2015.
4. In case the number of applications exceeds the number of places available at reduced fees, priority will
be given to:
a.
younger people
b. people applying for a course held in their region
5. Non-European members need to contact ESTRO office to check eligibility
*Important NOTE: Sponsored candidates are not entitled to reduced fees
How to apply
Applications forms (1) and CV (2) for the reduced fees need to be submitted to the ESTRO Office –
Education Department by email: [email protected].
List of eligible Countries
• All Specialties: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia,
Greece, Hungary, Latvia, Lithuania, Macedonia, Moldova, Montenegro, Poland, Portugal, Romania,
Russian Federation, Serbia, Slovak Republic, Slovenia, Spain, Ukraine, Turkey.
• RTTs and Physicists only: Cyprus
• RTTs only: Italy
ESTRO School, Rue Martin V No. 40, 1200 Brussels BELGIUM Tel: +32 2 775 93 40 Fax: +32 2 779 59 94
E-mail: [email protected]
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(1) Application Form (date _/_/2015)
(1) Please save this file, complete it and mail it to [email protected]
I am applying for the course (please tick the box on the left)
Tick
box
Date
Title
City
Country
Feb 1-4
Comprehensive quality management in RT - Part II - Quality
assessment & improvement
Turin
Italy
Feb 22-25
ESTRO/ESNM course on molecular imaging and radiation
oncology
Madrid
Spain
March 7-11
Basic clinical radiobiology
Brussels
Belgium
March 15-18
Modern brachytherapy techniques
Limassol
Cyprus
May 10-14
Image-guided radiotherapy in clinical practice
Prague
Czech Republic
May 14 -16
Cancer survivroship
Brussels
Belgium
June 8-11
Multidisciplinary management of breat cancer
Florence
Italy
June 14-18
Physics for modern radiotherapy
Ljubljana
Slovenia
June 28-30
Brachytherapy for prostate cancer
Vienna
Austria
Copenhagen
Denmark
June 28 - July 2 Advanced skills for treatment delivery
Aug 30 - Sept 3
Clinical practice and implementation of image-guided stereotactic
Dublin
body radiotherapy
Ireland
Sept 3-5
Haematological malignancies
London
United Kingdom
Sept 13-17
Imaging for physicists
Amsterdam
the Netherlands
Sept 13-17
Basic treatment planning
Lisbon
Portugal
Sept 18-22
Advanced treatment planning
Lisbon
Portugal
Oct 4-6
Multidisciplinary management of central nevous system tumours
Turin
Italy
Oct 4-8
IMRT andother conformal techniques in practice
Brussels
Belgium
Oct 4-8
Target volume determination - from imaging to margins
Budapest
Hungary
Oct 15-17
Multidisciplinary management of lung cancer
Athens
Greece
Nov 01-05
Image-guided radiotherapy and chemotherapy in gynaecological
cancer, focus on adaptive brachytherapy
Utrecht
the Netherlands
Nov 15-18
Combined drug-radiation treatment: biological basis, current
applications and perspectives
Vienna
Austria
Nov 19 - 21
Paediatric radiation oncology
Izmir
Turkey
Dec 6-9
Quantitavie methods in radiation oncology: models, trials and
clinical outcomes
Brussels
Belgium
ESTRO School, Rue Martin V No. 40, 1200 Brussels BELGIUM Tel: +32 2 775 93 40 Fax: +32 2 779 59 94
E-mail: [email protected]
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Your details:
Family name
First name
Date of birth
ESTRO Member
Type*
*Please make sure you are an ESTRO member for 2015 by the moment you send in your application
form
Institute
Institute Address
Zip code
Town
Country
Phone number
e-mail (**)
Speciality





Radiation oncologist
Clinical oncologist
Medical physicist
RTT
Other (please specify) ……………………………………………………………………………..
** All correspondence relating to your application will be sent to the e-mail address provided
ESTRO School, Rue Martin V No. 40, 1200 Brussels BELGIUM Tel: +32 2 775 93 40 Fax: +32 2 779 59 94
E-mail: [email protected]
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(2) Curriculum vitae
Education (please list only education related to your actual profession):
Year/period
Institute/University
Professional Activity/Experience:
Year/period
Institute/University
Position
How would you rate your English, from 1 (basic) to 5 (mother tongue):
Rate
ESTRO School, Rue Martin V No. 40, 1200 Brussels BELGIUM Tel: +32 2 775 93 40 Fax: +32 2 779 59 94
E-mail: [email protected]