Application Form: Observational Internship

I. PERSONAL INFORMATION

Full Name: *

Date of Birth: *

Email Address: *

Passport ID: *

Passport Attachment (Max 5MB): *

How did you hear about the internship at SMS Unicamp? *
Choose oneUniversity International OfficeSocial Media / WebsiteProfessor RecommendationOther

If other, please specify

II. ACADEMIC BACKGROUND & INTERESTS

Name of Institution: *

Faculty/School: *

Country: *

International Office Contact:

Name of Coordinator/Responsible Person: *

Email/Phone: *

Areas of Interest (e.g., Cardiology, Surgery, Pediatrics) [in order of interest]: *

III. STATEMENT OF INTENT

Personal Statement (Briefly introduce yourself and your motivation): *

IV. REQUIRED DOCUMENTATION (Attachments)

Please ensure all files are clearly named (e.g., Name_Surname_Transcript.pdf)

1. Presentation Letter: *

2. Declaration of Regularly Registered Student: *

3. Official Academic Records / Transcripts: *

V. PROPOSED INTERNSHIP PERIOD

The internship must have a maximum duration of 3 months.

Proposed Start Date: *

Proposed End Date: *