2006
Award: Dr Anna Taddio
Click to see award citation
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2006 Call for Nominations Due Date for Nominations: March 15, 2006 (now closed) The
Special Interest Group on Pain in Childhood, International Association
for the Study of Pain ®, is pleased to announce the Call for Nominations
for a Young Investigator Award in Pediatric Pain. The prize is awarded
every three years at the International Symposium on Pediatric Pain (ISPP).
NOTE:
Applications and all supporting documentation must be submitted
in English. |
APPLICATION FORM
Please select and copy the tables below into your
word processor
or download the form here
(Rich Text Format for use in Word or WordPerfect)
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SECTION 1 PERSONAL DETAILS
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Last Name (Family Name)
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First Names (Given Names)
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Title (e.g., Dr, Mr, Ms)
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Date of Birth
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Mailing address for
correspondence |
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Email address
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Telephone
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( include country and area codes)
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Fax
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(include country and area codes)
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SECTION 2 PROFESSIONAL
AND EMPLOYMENT DETAILS
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Current place of employment
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Your position
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Your highest degree (e.g., PhD,
MD)
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Date when highest degree was received
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Institution from which highest
degree was received
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Other qualifications / degrees
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Professional affiliations and society
memberships in pain
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