IVI's 18th International Vaccinology Course Registration

Registration Form Instructions: Please include all relevant information. If you wish to apply for fellowship, Please complete PART II of the form.

Personal Information


PART I : Registration

1.Personal Information

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Sex (required)
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Pre-existing medical condition we should be aware of (required)
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Emergency contact:
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2.Education (Start with most recent)

3.Present affiliation

*Note : Includes the following :

Any officer or employee of a government or any department, agency or institute of a government;
Any person acting in an official capacity for or on behalf of a government or any department, agency, or institute of a government;

Any officer or employee of a company or business owned in whole or part by a government;

Any officer or employee of a public international organization such as the World Bank or United Nations;

Any officer or employee of a political party or any person acting in an official capacity on behalf of a political party;

and/or any candidate for political office.

4.Past working experience (Start with most recent)

5.Publications (Maximum 5)

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PS: If you do not receive a confirmation of registration per email, please contact ivivaccinology-ap@ivi.int.
PART II : FELLOWSHIP APPLICATION

IVI provides fellowships to people from low- and middle-income countries who are otherwise unable to attend the course. A select number of fellowships are competitively awarded to individuals with financial need, leadership potential, and who have made contributions to public health in their country. The fellowships are an essential component of the course, reflecting IVI’s mission and values.

If you have previously applied for this course fellowship and not been accepted, please state the years you applied:

LETTER OF RECOMMENDATION**(from institutional head or mentor)
** Scanned / faxed copy of letter of recommendation is acceptable.
I certify the information I provided on and in connection with this form is true, accurate and complete. I understand that any false statements may be grounds for disqualification from the fellowship