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IFMSA APPLICATION FORM FOR

Internships at the World Health Organization

Full Name (Surname, First Name, Middle Name)

Age Date of Birth

Citizenship Place of Birth

Civil Status Passport Number

Passport Date of Issuance Passport Date of Expiry

Contact Number E-mail Address

Name of Medical School

Name of Degree Program

Year in Medical School Expected Year of Graduation

Name of NMO

Position in NMO (if any)

Appying for internship under which WHO Department?Human Resources for Health Unit

For the period ofSeptember 2, 2013 August 31, 2014

How manydays/weeks?

Expected Start Date Expected End Date

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How do I plan to finance my internship?

Do I need a support letter from IFMSA for my personalfundraising? (Yes/No)

Past experience relevant to departments work (3 sentences)

Three most important achievements1.2.3.

Please submit this form to lwho@ifmsa.org in MS Word form (notpdf), along with your curriculum vitae, motivation letter, and letter

from NMO president.

mailto:lwho@ifmsa.orgmailto:lwho@ifmsa.org