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HELAERS RESEARCH PRIZE FOR STROKE

PRIX HELAERS POUR LA RECHERCHE SUR LES ACCIDENTS VASCULAIRES CÉRÉBRAUX (AVC)

ONDERZOEKSPRIJS HELAERS VOOR BEROERTES

Application form 2018

The application form must be submitted in English. All section should be duly completed, failing which the application shall be discarded. The application file shall not be returned to the applicant.

The application form must be received in paper and electronic format at the latest on May 31.

The paper format must be sent at the following address:

Dr André PEETERS

President of the BSC

Cliniques UCL Saint-Luc - Neurologie

Avenue Hippocrate 10

1200 Woluwé-Saint-Lambert (Belgium)

The application form must be sent by email at the following addresses:

To Doctor André PEETERS, President of the Belgian Stroke Council

Email : andre.peeters@uclouvain.be

To Ms. Nicole BRAEKMAN, President, Fondation Helaers

Email: fondation.helaers@skynet.be

Helaers Research Prize for Stroke – Application Form 2017

1. Overview detailing the Project (of 2 pages maximum), highlighting that the conditions set out above in the article are fulfilled together with a translation of the overview in French or Dutch at the choice of the applicant

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

(translation)

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

2. Detailed description of the project (maximum word count 2500, not including references)

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

3. Detailed resume of the Researcher, including affiliation and e-mail address

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

4. List of his publications, highlighting that the conditions set out in Article 3 are fulfilled

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

5. Description of the Researcher’s integration in the Belgian academic, scientific or clinical community.

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Helaers Research Prize for Stroke – Application Form 2017

6. A copy of any additional document (publications, sponsorship letter, any other document of major importance) can be enclosed to the application. It is strongly advised to enclose with the application form attestations and support letters. Although these documents are not compulsory, they can inform the deliberations of the Jury concerning the granting of the Prize. Such documents must be part of the application file.

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Helaers Research Prize for Stroke – Application Form 2017

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Helaers Research Prize for Stroke – Application Form 2017

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