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Application for Fellowship Program

By RM Solutions - Posted on 04 February 2009

Dar Al Fouad Hospital

In Collaboration with
Cleveland Clinic International

I. Application 2010 for fellowship in:

Specialty: *

One Specialty Only

II. Personal Information

First Name: *

Middle Name: *

Family Name: *

Present Address: *

City: *

Country: *

Home Telephone No.: *

Mobile No.: *

E-mail Address: *

Fax Number:

(If international, please provide country and city codes)

III. Education

High School

High School Name: *

High School Grade: *

Date: *

Medical School

Medical School Name: *

Medical School Dates

From: *

To: *

General Graduation Degree: *

Master Degree

Year: *

Grade: *

University: *

Residency Period

From: *

To: *

Hospital: *

Post Graduate Studies

1- Post Graduate Study

Examination name:

Date:

Scores:

2- Post Graduate Study

Examination name:

Date:

Scores:

3- Post Graduate Study

Examination name:

Date:

Scores:

4- Post Graduate Study

Examination name:

Date:

Scores:

IV. Experience

1- Institution name

Institution name:

Position:

From:

To:

Job Description:

Reason for Leaving :

2- Institution name

Institution name:

Position:

From:

To:

Job Description:

Reason for Leaving :

3- Institution name

Institution name:

Position:

From:

To:

Job Description:

Reason for Leaving :

V. Additional Information

1. Do you have a military commitment?: *

Yes

If Yes

Starting:

For: Years

In:

2. Do you hold a local medical license?: *

Yes

References and Supporting Documents

If the candidate is selected for an interview the following documents should be provided during interview:-

Personal Statement
Two letters of recommendations
A copy of the medical diploma and master degree
Photo ID
A Proof of residency period or any other training period

The Policy of Dar Al Fouad Hospital is to provide equal opportunity to all of our employees and applicants for employment. Decisions concerning employment, transfers and promotions are all made upon the basic of the best qualified candidate.

Application for Fellowship Program

Dar Al Fouad Hospital

References and Supporting Documents

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