Awards Ceremony Information Request
We kindly ask you to complete the following form with details regarding the financial aspects of the awards and basic information. This will help us present you and your scientific achievements leading up to the Awards Ceremony.

Before you proceed, please prepare a short CV that will be published on our website, along with your photo. You can find an example of the CV here: IMA Finalist CV Example. You can see previous presentation of finalists here: Finalists & Winners.

Please note that we will send you the final presentation for your review and approval.


Personal information

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Your Title – multiple choice possible:
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First Name
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Last Name
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Home Address
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Postal Code and Town
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Country of Residence
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Mobile Phone
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Tax Number
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Bank Account Number (EUR payments)
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Swift/BIC (bank code)


Career and research

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Brief CV in text
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Please upload portrait photo in highest resolution possible
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In your opinion, what is the importance of your awarded research for clinical practice and patients?


The person behind the research

To help us create a warm and engaging introduction, please share a few additional information.

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Why did you decide to become a doctor/pharmacist?
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What motivates you to do additional research work, how do you find the energy to do it?
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What do you enjoy doing outside of work?
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What does being selected as a finalist for the International Medis Awards mean to you personally?