ESC NURSING TRAINING GRANTS

APPLICANT Full Name:______

APPLICANT: Please forward this sheet for completion to your proposed future SUPERVISOR, once completed please include this completed document to your application

Future SUPERVISOR (during the ESC Nursing training grant period): the candidate has applied for an ESC Nursing Training Grant to be held in your Department. Could you please read the regulations for the Nursing Training Grant programme and then let the ESC have information on the following

  1. Length of time you have known the candidate
  1. The amount granted by the ESC is supposed to cover the running expenses (including daily subsistence of the awardee). Can this amount cover the cost of the proposed training period?

3.If it cannot, from what source will the deficit be made up?

  1. Describe the proposed training project

5.State your view on the candidate's ability and suitability for (further) clinical training and on any relevant points which you consider would be helpful to the ESC

6.CLINICAL APPLICANTS ONLY

  1. Would an honorary clinical contract be sought for the candidate ? YES / NO

If YES please indicate

  1. Level
  1. number of sessions
  1. specialty
  1. health authority

7.Name and title of

  1. Head or Supervisor of Department
  1. Supervisor

Address of Department

Email:

8.I am aware that an award under this scheme is normally administered through the medium of a fixed-term contract of employment for the period of the grant, entered between the training grant recipient and the host institution. I confirm that I support this application and that if an award is made, the candidate would be accepted in the Department in accordance with the regulations and terms of employment for ESC Training Grants.

Electronic Signature of SupervisorDate

(scanned signature)

Personal Data Privacy

The information collected is subject to a computerised process to record, evaluate and track the grant application. The recipients of the data are:

• The staff in charge of processing ESC Research and Training Grant applications and, in the case where a grant is awarded, the staff in charge of paying the grant monies

• The persons in charge of the assessment of the applications – The ESC Grants Committee

In accordance with the French law N°78-17 of January 6, 1978, amended in 2004, relating to the protection of individuals with regard to the processing of personal data, you have a right to access and rectify information concerning you, which you can exercise by contacting:

European Society of Cardiology

Les Templiers, 2035 Route des Colles

06903 SOPHIA ANTIPOLIS, France

You can also, for legitimate reasons, oppose the processing of data about you.