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A P P L I C A T I O N
XIII EAMA Training Course 2019-2020
* obligatory fields
Last name and first name(s)
Date of Birth (dd-mm-yyyy)
Place of birth
Enter your email address
Name of the hospital
Is your employer conected to a University?
Enter your email address
Website of your institute
Field of interest and expertise
Field of interest
Field of expertise
Please attach a one-page
summary of research programmes, achievements and papers accepted and/or published:
Upload summary of research programmes
Please attach a copy of your
written in accordance with the national standards (see the template available to download on the eama.eu website).
Upload curriculum vitae
Please attach an
of the university in which you plan your career.
Upload endorsement letter
What international experience do you have so far, related to your professional work?
Why do you wish to attend the European Academy of Medicine of Ageing (EAMA)?
Motivation for EAMA
How do you envision your career plan?
By ticking the box, I certify that my spoken English is good enough to follow lectures and to participate in discussions.
Course cost: 10800 Euros and 80 Euro Diploma fee, paid in 2 instalments. This package includes tuition, hotel accomodation and meals. (four weeks of 5 days) Travel expenses are not covered by the coursefee.
Do you hereby apply for a scholarship of the EuGMS?
The scholarships are aimed at supporting young, academically-oriented investigators and clinicians in the field of geriatric medicine, living in European countries with limited financial resources.
If yes, which category suits your current situation?
MD members of staff with a PhD degree and experience in clinical work, research and education of students of departments for geriatric medicine of university hospitals.
MD members of staff with a PhD degree and experience in clinical work and participating in the training of geriatricians in departments for geriatric medicine of general hospitals with specialist training facilities.
MD members of staff preparing a PhD degree and experience in clinical work, research and education of students of departments for geriatric medicine of university hospitals.
MD members of staff without a PhD degree, but with experience in clinical work and participating in the training of geriatricians in departments for geriatric medicine of general hospitals with specialist training facilities
Do you receive any financial support for attending the EAMA? If yes, please specify.
By ticking the box, I certify that the information provided in this application is true, correct and complete. I understand that any misrepresentation may be cause of refusing or revoking admission onto the course.