Professor Heimburger Award Application

Name of Applicant

Medical Degree / PhD Obtained (title, year and place)

Hospital / Institution (name and address)

Title of Research Project

Is this research project pre-clinical or clinical? Pre-Clinical Clinical

Email for contact

Other involved scientists (for each provide name, academic title and brief description of involvement in the research project)

Please upload the following documents below:

Short CV (max. 1-5 pages)
Research proposal (one page, including name and institute)

If you have any queries or issues with uploading your short CV and/or one-page research proposal, please contact the Heimburger Award Facilitator at Heimburger.Award@cslbehring.com.

By submitting this form, you are consenting to disclose any information provided, including your name, email address, address, telephone number, and any other information (collectively "Personal Information") to CSL Behring and its representatives, agents, and contractors (collectively "CSL Behring Entities") and to receive communications with relevant information from CSL Behring Entities. You will have the ability to opt out from receiving communications from CSL Behring Entities at any time. CSL Behring and CSL Entities will not sell your personal information.

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Please confirm:

Herewith I confirm that I have read and meet the below eligibility criteria as well as the details regarding the application procedure

Eligibility criteria

The awards are reserved for researchers who hold a medical degree or a PhD; applicants with less than five years post-doctoral research experience or clinical practice experience will be prioritized.

The awards are available for clinical and preclinical research in the areas of:

Inherited bleeding disorders

and

Acquired bleeding disorders

Multiple applications for different research proposals by the same applicant in the current award cycle will not be considered and matching funds are not a prerequisite for this award.

Thank You

Your application is being processed.