fellow stipend transfer of funds – DIVERT Mental Health

Fellow Stipend ToF Info – 2024

Fellow Member Information

I am a:(Required)

Master’s, PhD, or Postdoc trainee

ECR Mentee

Name(Required)

First Last

Confirmation of DIVERT Fellow's Supervisor's Information:

Name(Required)

First Last

Title(Required)

Email(Required)

Institutional Signatory (Signing on Behalf of the DIVERT Fellow's Supervisor):

Name(Required)

First Last

Title (Name of Position)(Required)

Administrative Contact at DIVERT Fellow Supervisor's Institution:

Name(Required)

First Last

Title (Name of Position)(Required)

Email(Required)