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MedicineBrown UniversityUniversity of MichiganCornell UniversityFlorida Atlantic UniversityLudwig-Maximilians UniversityJulius-Maximilian UniversityBrandenburg Medical School Theodor FontaneShantou University Medical collegeThe University of SydneyUNSW SydneyOtherAverage/ GPA(Required)Home University Name and Address(Required)Clinical Student since (year)(Required)Desired HospitalRank from 1 to 5. 1 being your preferred preference and 5 being the least.Bnei Zion(Required) 1 2 3 4 5 Carmel(Required) 1 2 3 4 5 Haemek, Afula(Required) 1 2 3 4 5 Hillel Yaffe, Hadera(Required) 1 2 3 4 5 Rambam(Required) 1 2 3 4 5 Desired DepartmentThe top one being your most desired choice1.(Required)2.(Required)3.(Required)4.(Required)5.(Required)Details of Requested 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of Hebrew(Required) None Fair Very good Do you have any medical/physical conditions that might influence your visit?(Required) Yes No Please specify(Required)DocumentaionPhoto(Required)Max. file size: 35 MB.CV(Required)Max. file size: 35 MB.Original Grade transcript(Required)Max. file size: 35 MB.A letter of interest for a clinical elective at the Technion(Required)Max. file size: 35 MB.Letter of recommendation from a home faculty member #1(Required)Max. file size: 35 MB.Letter of recommendation from a home faculty member #2(Required)Max. file size: 35 MB.Verification of Immunization - you need to fill in the document in the link below and to upload to the form(Required)Max. file size: 35 MB. https://intech-med.net.technion.ac.il/files/2023/07/Immunization-Requirements_2023.pdfVerification of health insurance(Required)Max. file size: 35 MB.Photo of passport(Required)Max. file size: 35 MB.This field is hidden when viewing the formsumPhone
