Internship Application Form Please enable JavaScript in your browser to complete this form. - Step 1 of 4Are You Applying as an Institution? Then click Here! Training Institutions Application Form Otherwise, continue as a single Intern Applicant. Application Guidelines Click Here To get started by reading these guidelines carefully, Personal Information Date of Application *Name *FirstLastEmail *Date of Birth *Phone *Nationality *UgandanOthersName of Next of Kin *FirstLastPhone of Next of Kin *NextEducational Background Training Institution *Fill in your University, school, institute etc.Course (Ongoing or Completed) *Fill in the relevant course of studyMajor Area of Study *Date of Completion of Studies/Graduation *Insert date when you completed or when you will complete studiesNextPlacement Details Position applied for *Pick Internship type from drop down Pre - Graduate InternshipPost - Graduate InternshipOther Type of placement'Other' Internship TypeExplain the internship type you apply forPreferred Department *Pick one department from drop downInternal MedicineObstetrics & GynecologySurgeryPediatricsCommunity HealthSupport ServicesDuration of Placement *Enter number of Months for placement (Max 6)Start Date *Select date when placement beginsEnd Date *Select date when placement endsReason for PlacementNextUploads Upload Introductory Letter * Click or drag a file to this area to upload. Attach Letter from your University/institution Upload Registration certificate/Practicing License Click or drag a file to this area to upload. Where applicable e.g. Doctors and Pharmacists, upload valid licensesUpload Copy of National ID or School ID or Passport * Click or drag files to this area to upload. You can upload up to 2 files. Upload the front and back view of your IDUpload Passport Size Photo * Click or drag a file to this area to upload. Updating preview…Below is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit
