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Application form for the
Hans-Peter Geh Grant
for IFLA Conference Participation

Note: This form can not be sent over the Internet it should be filled out, printed, and then either mailed or faxed to the address below

Deadline for application: 1 February of each year.

The applications must be accompanied by a Statement of Intent in English, French or German (not more than 3 pages), which should include:
  • the reasons for application specifying the seminar or conference the applicant wishes to attend
  • a proposed budget, including financial sources from elsewhere
  • a curriculum vitae

1. Complete the application form:

Full Name:

Date of Birth:(yyyy/mm/dd):

Sex: Male / female.

Nationality:

Private Address:



City: Province/State:
Country: Postal Code:

Office Address:



City: Province/State:
Country: Postal Code:

Home Telephone:

Office Telephone:

Home Fax:

Office Fax:

E-mail:

WWW-site:

Present position:

Knowledge of languages (Written and spoken):
1. 2.
3. 4.
 

Professional/Academic Qualifications: ___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

 

Date _______________________________________________

The undersigned, taking note of the conditions of the Prize wishes to be considered a candidate for the said Prize.

Signature __________________________________________

2. Mail or fax this form with the appropriate information to:

Secretary General
IFLA Headquarters
P.O.B. 95312, 2509 CH The Hague
Netherlands
Fax: *(31)(70)3834827
E-Mail: IFLA@ifla.org

Note: This form can not be sent over the Internet, it must be filled out, printed and then mailed or faxed to the address above.