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ABOUT
OUR STORY
OUR VALUES
OUR IMPACT
OUR PEOPLE
CONTACT
OUR WORK
WHAT WE DO
CURRENT PROJECTS
PREVIOUS PROJECTS
SERVICES
TRAINING
COURSE 2019
CONSULTANCY
GET INVOLVED
VOLUNTEER
PAID ROLES
FUNDRAISE
NEWS & STORIES
|
DONATE
APPLY - PGF PARTICIPANT
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Email Address
*
Full Name
*
Phone Number
Name of organization/clinic you currently work in (Government or non-government)
*
Clinic location in camps or host communities
*
Have you completed your MBBS / MBChB and are fully registered with the Bangladesh Medical and Dental Council (BMDC)
*
Yes
No
Please provide your medical registration number. If you do not have a number please explain why not
*
How many years since you've graduated from medical school?
*
Do you have good command over conversational English?
*
Yes
No
Do you meet the essential requirements for the PGF (See the top of the page to download)
Yes
No
Other
Other
Date available to attend PGF
*
Cohort C: June 13, 2019 - September 9, 2019
Cohort D: September 19, 2019 - December 9, 2019
Can you attend either Cohort C or D if accepted?
*
Yes
No
If you answered no to above, please explain
Does your supervisor/organization consent to you attending the PGF?
*
Yes
No
Please describe in detail why you are interested to attend the PGF and how this will benefit your career
*
0 / 500
If accepted onto the PGF, do you agree to attend a minimum of 75% of the lectures and participate in at least 2 clinical shadowing opportunities?
*
Yes
No
If accepted onto the PGF, do you understand and accept that if you do not attend more than 75% of the PGF you will not pass the PGF? (See Participant Form for list of holidays and days off)
*
Yes
No
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