Grant Application

Elan MED has developed a user-friendly online venue for direct submission of educational grant requests.

NOTE: Requests must be submitted no fewer than 60 calendar days prior to the start date of your planned activity. Elan MED reserves the right to deny requests not submitted in this timeframe.

Please click here for Elan's privacy policy and contact information.

It is necessary for Elan Pharmaceuticals, Inc. to verify that the grant monies provided to institutions are in fact used for the purpose specified in the application. Therefore, for approved applications, within thirty (30) days of the completion of the approved program, the requesting institution will provide to Elan written documentation that the Program occurred as planned. In the case of a CME program, symposium, lecture, grand rounds or other similar activity, please provide Elan with a letter summarizing the event, including the date, location, topic(s) and number of participants. In the case of textbook purchase, newsletter, educational material or other similar matter, please provide Elan with written documentation of the purchase (receipts) or preparation and dissemination (date and number of recipients) of materials.

Title
First name Last name
Contact Title Institution name Address Address 2 City
State
Zip Code Zip Code (full) -
Phone - -
Phone Ext.
Fax - -
Email Confirm Email
ACME
Business Tax ID -
Grant Request Letter
Program Agenda Document
Program Agenda Note
Title Of Activity
Purpose Of Activity
Amount of Request .
Presentation Date 1
Presentation Time 1 : Presentation Location 1
Presentation Date 2
Presentation Time 2 : Presentation Location 2

Presentation Date 3
Presentation Time 3 : Presentation Location 3