departures@wolissoproject.org
Application Form
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Before Filling in the AF you must accept the entire WP statute, so please read it carefully.
Name Surname
Phone number E-mail
Address, City and Country
Academic year Average marks University
Previous collaboration with IFMSA Yes No
If yes, explain what
English speaking Poor Average Good Perfect
Which departure date do you prefer? (two options, month/yy)
International medicine experiences (Meetings, other…).
Describe your motivation. (at least 5 lines)
Describe your expectations. (at least 5 lines)
Hereby I declare to have read and to accept the entire WP statute: Yes No
Italian Privacy application:
L' Inviante accetta che il trattamento dei propri dati personali sopra indicati sia necessario per la processazione della sua richiesta. Questi dati non saranno comunicati o diffusi a terzi, senza il consenso del suddetto Inviante, nel rispetto delle norme in materia di trattamento dei dati personali. Titolare del trattamento dei dati personali inviati č Wolissoproject.org