Application for assistance with funding to attend NZSHS Conference in Christchurch from 7 - 9 September 2017.

The New Zealand Sexual Health Society (NZSHS) is a group of professionals working or interested in the field of sexual health. The Society was established for educational and charitable purposes within New Zealand. Membership is multidisciplinary and includes doctors, nurses, counsellors, educators, health promoters, researchers, students and others in Public Health working in the field of sexually transmissible infections, including HIV/AIDS, as well as broader sexual and reproductive health.

To support its educational objectives, the Society organizes an annual conference, which includes an Annual General Meeting (AGM) and an academic programme. The Society recognises that some health professionals experience difficulty in securing financial support to attend conferences and therefore provides some funding towards conference registrations. This funding is designed to help individuals who otherwise may not be able to attend the conference and for whom attendance at the conference would be beneficial in terms of education, professional development and networking opportunities.

There are 20 scholarships, each to the value of $150, available for the 39th annual NZSHS conference 7 - 9 September 2017 in Christchurch. Funding will be to contribute to the conference registration fee only. Applicants must cover their own travel and accommodation and other costs.

Applicants will be considered from anyone likely to benefit from attending the annual NZSHS Conference. Successful applicants will be required to complete a post-Conference brief online survey, to provide feedback about their experience, and a link will be emailed after the Conference. Applications must be received by Friday 28 July 2017 to be eligible for consideration. Individual applicants will be notified of their application.

Please fill out the application form and return to:

NZSHS Conference 2017 – Funding Application
c/- ForumPoint2

PO Box 1008, WMC

Hamilton

E:

Note: Individuals may also want to consider other potential funding sources; for example, BreakOut is a searchabledatabase that holds information on funding schemes that cover study, professional development, and research and community projects. The database can be accessed for free at public libraries and other locations; check out this link to find where you can use BreakOut at a public site. www.fis.org.nz/products/breakout/public-locations/

FUNDING APPLICATION REQUEST
PLEASE RETURN COMPLETED FORM BY Friday 28 July 2017, AT THE VERY LATEST TO:
E: / Postal:
NZSHS Conference 2017- Funding Application
c/- ForumPoint2, PO Box 1008,WMC, Hamilton 3240, New Zealand

Please tab to enter into fields and complete all fields:

YOUR CONTACT DETAILS
Name
Organisation
Professional Role
Ethnicity / Which ethnic group do you identify with?
·  New Zealand European [ ]
·  Maori [ ]
·  Samoan [ ]
·  Cook Island Maori [ ]
·  Tongan [ ]
·  Niuean [ ]
·  Chinese [ ]
·  Indian [ ]
·  Other (such as Dutch, Japanese, Tokelauan) [ ]
o  Please state______
Telephone
Email
Are you a NZSHS member? / □Yes □No
Currently, do you have any funding available to assist you attend the conference? (include partial funding) / □Yes □No
AMOUNT OF FUNDING IF AVAILABLE:
WHAT INTERESTS YOU ABOUT THIS YEAR’S CONFRENCE PROGRAMME? Please explain:
HOW WILL ATTENDING THE 2017 NZSHS CONFERENCE BE BENEFICIAL IN TERMS OF YOUR EDUCATION, PROFESSIONAL DEVELOPMENT AND NETWORKING?