FOR TROPICAL MEDICINE AND INFECTIOUS DISEASES ELECTIVE
DATE OF BIRTH
ADDRESS (For Future Correspondence)
E-MAIL ADDRESS (Please Print Clearly)
PHOTOGRAPH (Passport Size jpg or png)
EELECTIVE ATTACHMENT DETAILS
ABOUT YOUR HOME INSTITUTION
NAME OF YOUR UNIVERSITY/MEDICAL SCHOOL
(Include the Address)
PRESENT YEAR OF STUDY
TOTAL DURATION OF THE MEDICAL COURSE
Tropical medicine and infectious diseases elective students are required to pay a fee using online payment gateway as follows:
A brief CV and a letter from your university/medical school confirming the studentship and approving the elective attachment should be sent via e-mail to the elective coordinator (firstname.lastname@example.org).
Please complete all sections before you click submit.
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