South African Society for Basic and Clinical Pharmacology Young Pharmacologist Travel Award The South African Society for Basic and Clinical Pharmacology will award five students with R5,000 each to use towards the attendance of the 53 rd Congress of the South African Society for Basic and Clinical Pharmacology in Pretoria, South Africa. The application deadline is 30 August 2019. Please complete the form and e-mail back to Ms Petunia Degashu ([email protected]). Personal details Title, name and surname: Institution: Full address: Telephone number: Mobile number: E-mail address: Society membership number: Membership paid? Yes No Abstract information Did you submit an abstract Yes No Title of abstract: Finance Did you apply for any other funding to attend conference? Yes No If yes, what other funding did you apply for? Were you successful in the funding application? Yes No If yes, please supply amount received: R Please specify your specific costs to attend the congress. Travel Cost Air ticket Ground travel from and to airport Other transport Accommodation day(s) @ R per day Registration fees Other (specify)