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titleOpenMRS Worldwide Summit 2015

Travel grant applications are no longer being accepted for the 2015 OpenMRS Worldwide Summit. Thank you for your participation!

 

One of the ways that OpenMRS Inc. supports the OpenMRS open source community is by sponsoring contributors to attend OpenMRS events such as conferences and hackathons. The organization provides travel grants for speakers and contributors to events such as OpenMRS Implementers Meetings, OpenMRS Leadership Camp, and the OpenMRS Worldwide Summit, among other events. 

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titleApplication Form - Email to community@openmrs.org
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Personal information

  1. First/Given name(s):
  2. Family name:
  3. Employment or project affiliation (if any):

Event information

  1. Event name: _____ Implementers Meeting / Leadership Camp / Worldwide Summit (delete as appropriate)
  2. Role at the event: [ ] Participant [ ] Speaker [ ] Organizer [ ] Other, please specify
  3. Traveling from (city & departure date):
  4. Traveling to (city):
  5. Date of return to city of original departure:

Statement of interest

Write no more than 150 words for each of the following questions:

  1. Why should you attend the event?
  2. Why should you be sponsored?
  3. Can you attend without sponsorship?
  4. Include relevant contributions
  5. Number of years using or contributing to OpenMRS

Financial request details

  1. Your total estimated travel costs (amount and description):
  2. Your total estimated lodging costs (amount and description):
  3. Other costs (amount and description):
  4. Requested subsidy total: (How much of the above costs you would like covered by OpenMRS Inc.)
  5. How you will want to be reimbursed: (delete as appropriate)
    1. Check in US funds from a US bank made out to ______________________ and mailed to ___________________________
    2. Bank transfer
      1. Account holder's name and address:
      2. IBAN (account number if IBAN is not available):
      3. SWIFT or BIC:
      4. Bank name and address:
      5. Currency of account:

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