International Visiting Student Application

International Visiting Student Application

First Name*

Last Name*

Email Address*

Home Institution*

Country of Home Institution*

First Choice Elective*

Select your first choice elective course. You application will be routed here first.

Select

Second Choice Elective*

Select your second choice elective course. We will route your application here second if your first choice is not available.

Select

First Date Preference*

Select your first date preference for an elective.

Select

Second Date Preference*

Select your second date preference for an elective.

Select

Upload all required documents here (incomplete applications will not reviewed)*

All forms can be found on our webpage.

Application Form
Sponsor Agreement Form
AAMC Immunization Form
Medical Malpractice Coverage Form or proof of personal medical malpractice coverage
Background Check Form or Proof of Completed Background Check
HIPAA Training Document
Official Transcript
CV/Resume
TOEFL Exam Results (if applicable)

Drag and drop files here or

I have uploaded my Application form:*

Ensure the course and dates you applied to are those that are actually available to international visiting students. Dates are fixed and inflexible.

I have uploaded my Sponsor Form:*

I have found a sponsor in my department and uploaded the signed sponsor agreement form.

I have uploaded the AAMC Imunization Form*

I have uploaded proof of Medical Malpractice Coverage*

You must upload either the Medical Malpractice Form signed by your school representative that prooves they provide you with malpractice coverage. If the do not, you must upload proof that you have obtained personal malpractice coverage.

I have uploaded proof that I have completed a background check*

You must upload either the Background Check Form signed by your school representative that prooves they have completed a background check on you. If they have not, you must upload proof that you have obtained personal background check.

I have uploaded the signed HIPAA Training*

I have completed the provided HIPAA training and signed the form

I have uploaded my Official Transcript*

I have uploaded my current Curriculum Vitae(CV)/Resume*

I have uploaded my TOEFL Examination Results*

Select

Affiliation Agreement*

Who should we contact at your institution to work with on exectuing an affiliation agreement, if one is not already in place? (Name and Email)

Send me a copy of my responses

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