Educational Grants Application

This application form is intended for educational grants only, which include a payment or in-kind support to a third party organization to defray the costs of providing education that relate to disease states, conditions and treatments relevant to Getinge’s mission. Educational grants will not be made directly to individual health care providers.

We recognize the important role that educational grants play in our mission, both in benefits to patient care and the advancement of medical technology, treatment, and knowledge. On an annual basis, we receive hundreds of requests and we aim to provide responsible support. However, due to finite resources, not every quality program will receive support.

Submission of an application does not guarantee support. The Getinge Educational Grants Committee reserves the right to reject any application, as well as approve in full or only in part.

Please note that this form cannot be saved and completed later. Ensure that you have all required documents accessible for upload before beginning this form.

Instructions

Requests, including the required Application Form and all relevant applicable forms/supporting documentation must be submitted a minimum of sixty (60) days prior to the educational event.
Applications must be completed in English.
Getinge Educational Grants Committee will reach out to the requester for any additional information as warranted by the Getinge Global Educational Grants.
In case of any questions, please contact educationalgrants@getinge.com.

Requesting Organization

Document uploads - What type of grant request is this? *

Monetary Educational Grants

In-Kind Grants (Products / Services)

Formal letter of request on the organization’s letterhead

Program Agenda

Budget reporting form in the provided template

Product request form in the provided template

W-9 Form of the requesting organization

Organization Name *

Organization Type *

Contact Name *

Contact Title *

Street Address *

Address Line 2

City *

State *

ZIP Code *

Phone Number *

Email Address *

Organization Tax ID *

Educational Event Details

Event Name *

Event Start Date * +

Event End Date * +

Event Venue *

Event Location / Street Address *

City *

State *

Zip Code *

Event Website URL

Therapeutic Focus Area *

Describe the objectives of the Educational Event and the relevance of the event. *

Target Audience *

National

International

Number of Proposed Attendees *

Proposed Educational Methods *

Expected Learning Outcomes *

CME Accreditation *

Yes

No

Provide name of the accrediting body, address and details of the accreditation process

Total Budget of the event (please include currency)

Financial support amount requested from Getinge *

Currency *

Please describe in detail how the grant or donation will be used *

Have any other requests for commercial sponsorship such as booth space /exhibits been submitted to any other Getinge entities for support? *

Yes

No

Provide details of the nature of request and name of the respective Getinge representative

List all Getinge employees affiliated with your organization and the relationship (i.e. sales rep, volunteer, etc.), if applicable

+-

Acknowledgement *

The information provided in this application is complete, true, and accurate to the best of the requestor’s knowledge.

Any donation or grant provided is unrelated to Getinge products and will have no effect on future referrals of Getinge products.

The educational grant will not cover the costs linked to the organization of leisure/entertainment activities, to cover ordinary operating costs, and other budget items not directly linked to education.

Signature *

clear

Date * +