IOFF-Subspecialty Fellowship Application

Application for an IOFF-Subspecialty Fellowship award

For questions, please consult the FAQ's or contact cgo@ioff.org. If a question does not apply to you, please enter "no".
Which IOFF-Subspecialty Fellowship Opportunity do you wish to apply for?
Which subspecialty would you like to train?
Name.

Last NameGiven NameMiddle NameNamenssuffix
What name should appear on your certificate? Give your full name.
Date of Birth.

MonthDayYear
Your postaddress.
Your mobile number.

Country codePrefixNumber
Your email address.
Repeat your email address.
Your nationality.
Do you have a second nationality?
Your gender.
Your marital status.
Number of children.
Name of your emergency contact. Relation to your emergency contact.
Email address of your emergency contact.
Your current position.
Candidate's Plans. Please consider well your answers and explain in detail.
1. What exactly do you wish to learn and why? What is your motivation?
2. What are the practical implications of your fellowship for your own professional development?
3. What are your plans upon return to your home country? How will your home institute benefit from you attending the IOFF Subspecialty Fellowship Program?
Were you granted a fellowship before (e. g. SOE/AAO/ICO)? Which, in what year?
Qualifications and Honors in Ophthalmology. Incl. Ophthalmology Foundation Exams, COECSA and EBO certificates.
Your Employment History in Ophthalmology. List ALL your present and previous positions. Start with your residency training position.
Teaching Activity.
Volunteer/Charity Activity.
Conference Activity.
Research Activity.
Your Publications.
Upload area.

* Scan of your passport, * Picture portrait, * "Specialist in Ophthalmology" degree certificate, * Confirmation issued by your present chair that you have completed your Residency Training, * Recommendation letter of your present chair, * Recommendation letter of your previous chair, * Recommendation letter of the chairperson of your charity/voluntary work position (if any), * ICO Exams certificates and EBO certificate (if available). All documents should be duly signed, be stamped with institute's stamp and be issued in English language. If not issued in English language please include a certified translation of the document to the original version.
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What describes your language skills best. Enter the language and tick.

Rows	language	proficient	intermediate	basic
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Will you acquire basic knowledge of the language spoken in the host country?
Funding source.
Candidate's Declaration. Please read carefully and confirm.
DateTime
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Application for an IOFF-Subspecialty Fellowship award