EAHP-EPSA Internship Platform Application

EAHP-EPSA Internship Platform Application
Personal Information
Name*

First NameLast Name
E-mail*
Preferable starting date of internship*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferable length of internship*
Date of birth*

MonthDayYear
Gender*
Phone Number*

Area CodePhone Number
Emergency contact name*
Emergency contact relation*
Emergency contact phone number*

Area CodePhone Number
Allergies:
Other health conditions:*
Spoken languages
Language 1*
Proficiency level (CEFR)*

A1A2B1B2C1C2
Official certification
Language 2*
Proficiency level (CEFR)*

A1A2B1B2C1C2
Official certification
Language 3
Proficiency level (CEFR)

A1A2B1B2C1C2
Official certification
Other spoken languages
University
University where you are enrolled or have completed your studies*
Faculty name and programme of study*
City and country of studies*
Year of studies/Year of graduation*
Total length of studies and number of ECTS credits*
Faculty contact person details

You are required to have a contact person at your faculty who commits to writing a recommendation letter for your internship and following your internship together with you. If you are a recent graduate, you also need to have a contact person at the faculty you graduated from.
Contact Person Name*

First NameLast Name
Contact Person Position*
Contact Person e-mail*
Contact Person Phone Number*

Area CodePhone Number
Internship Details
Hospital you are applying for*
Why are you motivated to apply for this hospital?*

0/300
Are you able to obtain insurance for the duration of your internship? (governmental or private*
Are you able to obtain accommodation for the duration of your internship?*
Attachments
CV (maximum 2 pages in length, pdf format)*

Upload a File

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Recommendation letter from faculty contact person (pdf format)*

Upload a File

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Copy of university transcripts (for total length of studies and number of ECTS credits)*

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EAHP-EPSA Internship Platform Application

Personal Information

Spoken languages

University

Faculty contact person details

Internship Details

Attachments