ACEM Foundation Foundational Emergency Medicine Training Program Scholarship

ACEM Foundation Foundational Emergency Medicine Training Program Scholarship

The scholarship is available for Aboriginal, Torres Strait Islander and Māori medical practitioners.
For more information, please refer to the ACEM Foundation Emergency Medicine Scholarship Policy.
Personal details
Name*

First NameLast Name
Membership number*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
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.
Are you of Aboriginal and/or Torres Strait Islander origin?*

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

YesNo
My date of enrolling in the ACEM Foundational Emergency Medicine Training Program is within 12 months.*

YesNo
Letter/s of support from a colleague and/or community elder which demonstrates a commitment to supporting you to complete the Foundational Emergency Medicine Training Program and highlights your links to your community.*

Cancelof

Signature and acknowledgement
Should I be awarded the ACEM Foundational Emergency Medicine Training Program Scholarship, I agree that I will be named through avenues such as the College’s annual report (Year in Review) for the applicable year, as well as other College sources.
Signature*

Clear
Date*

DayMonthYear
Date
Should be Empty:

Personal details