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Personal Information
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| Title * |
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| Forename(s) * |
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| Surname * |
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| Mobile Number * |
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| Email * |
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| Skype Id |
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| Telegram ID |
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Medical Degree Date*
[Please mention the date of your medical degree] |
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| Current country of residence*: |
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| Please state the reason to apply with us:* |
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Please state the date of your exam*
[please write 'N/A' if no exam has been booked yet.] |
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If you have previously failed the exam, please state the date(s) of the exam(s) that you failed, the score(s) that you achieved, as well as what the pass mark was on that occasion*
[please write 'N/A' if it is your first exam attempt.] |
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Upload ID |
Please upload proof of ID: passport/NID/driving licence.*
[We can accept any of the following formats: jpeg, jpg, pjpeg, x-png, png or pdf.] |
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Upload Photo [Optional] |
Please upload a recent photo of yourself.*
[We can accept any of the following formats:
jpeg, jpg, pjpeg, x-png, png or pdf.] |
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Username/Password (For Member Login)
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| Confirm Email |
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| Password |
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Course Details
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| Your selected course |
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| Please choose the month in which you wish to attend the session |
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| Please select the type of seat you are looking for: |
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| Due to the large number of doctors wanting a Masterclass seat, we are prioritising those who have previously failed the exam. If you would like to be considered for a priority seat, please submit evidence of your last failed attempt(s) – a copy of the fail transcript will suffice. |
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