Medicine Project Application Form
First Name
*
Last Name
*
Age
*
Gender
*
Please Select
Female
Male
Email Address
*
Phone number
In which city do you study medicine?
*
Please Select
Amsterdam
Groningen
Leiden
Maastricht
Nijmegen
Rotterdam
Utrecht
Upload your CV in English with a picture (in doc, docx, or pdf)
*
Upload a File
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Upload your motivation letter in English (in doc, docx, or pdf)
*
Upload a File
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Upload your list of grades (in doc, docx, or pdf)
*
Upload a File
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What is your land of preference if you are selected to take part in the Medicine Project?
Please Select
Ghana
Uganda
How long would you want to leave for?
Please Select
6 weeks
7 weeks
8 weeks
In the event that you are unable to leave in July/August (due to resits for example), AIESEC allows students to leave in the period of December. Would you leave during this period?
Yes
No
How did you hear about the Medicine Project?
Please Select
AIESEC member
AIESEC website
Facebook
Former participant of the Medicine Project
I am an AIESEC member myself
Lecture talk
Student association
University
Additional information or question regarding the Medicine Project?
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