IPNA Teaching Course Application
Course title
*
Type of course
*
Live, in person (with or without recorded presentations available online after the course)
Hybrid (combination of live and synchronous online access)
Virtual only (online, with or without recorded presentations available online after the course)
Teaching Course Director
*
First Name
Last Name
Course Director e-mail
*
example@example.com
Brief CV of the Course Director
*
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Since when is the Course Directors IPNA Member?
Has the course director organized any IPNA Teaching Course before?
Yes
No
Previous teaching courses organized
*
Post-meeting reports of previously supported IPNA Teaching Course)
*
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Teaching Course Details
Course Location, City, Venue
*
Country
*
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Canada Québec
Cayman Islands
Central African Republic
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Chad
Chile
China
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic)
Korea (Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua new Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Helena, Ascension and Tristan
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwic
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syrian Arab Republic
Taiwan (Province of China)
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Island
Uruguay
USA
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Start date
*
-
Month
-
Day
Year
IPNA Teaching Courses cannot be funded retrospectively, and applications must be submitted at least four months before the course date.
End date
*
-
Month
-
Day
Year
Fill in the same date if a one-day course.
Aims of the teaching course
*
Desired outcomes (max 1000 characters)
*
0/1000
Anticipated number of physical attendees
*
Anticipated number of online attendees
*
Anticipated number of attendees - comment
Name at least 1 confirmed IPNA regional speaker (IPNA Member)
*
Please note that invited speakers cannot be from the same institution as the teaching course organizer
Name at least 1 confirmed IPNA international speaker (IPNA Member)
*
Please note that invited speakers cannot be from the same institution as the teaching course organizer
Preliminary program
*
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Will you provide to IPNA the teaching course materials (slides, videos…) after the course?
*
Yes
No
Are CME Credits provided?
*
Yes
No
Registration fees for participants (in US$)
*
Sponsors
*
Detailed income and expenses (in US$). Please make sure that the budget is following IPNA Teaching Courses Policy and it is submitted in the requested template.
*
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Requested amount of IPNA contribution as per IPNA Policy (in US$)
*
Please indicate any local specific issues in particular travel, safety and health issues
*
Signed Endorsements by National and Regional Society
*
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