ACEM Foundation Joseph Epstein Scholarship

ACEM Foundation Joseph Epstein Scholarship
Form No: FND344
Last revised: April 2025

This scholarship is open to FACEM Trainees who identify as Aboriginal and/or Torres Strait Islander or Māori.

Applications will be reviewed by the ACEM Foundation Committee and ACEM Board.

Awardees will be notified by email.

Related Documents:
- FND367 ACEM Foundation Joseph Epstein Scholarship Policy
Personal details
Name*

First NameLast Name
ACEM ID*
Email*
example@example.com
Phone number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Eligibility
Applicants who meet the following criteria are eligible to receive this scholarship. (Please tick as applicable.)
Are you of Aboriginal and/or Torres Strait Islander origin*

Yes, AboriginalYes, Torres Strait IslanderYes, both Aboriginal and Torres Strait Islander
Do you have Māori whakapapa? (Are you a direct descendant of a New Zealand Māori tupuna?)*

YesNo
I am registered as a trainee in the FACEM Training Program*

Yes, I confirm
Signature*

Clear
Date*

DayMonthYear
Date
Submission
Applications are welcome at any time and will be reviewed by the ACEM Foundation Committee. All applicants who meet the eligibility criteria will be awarded the Scholarship, as determined by the ACEM Board. Awardees will be notified by email.

For more information, please refer to the Scholarship policy.
Should be Empty:

Personal details