Application form

Please complete the application form below to register for the 2024 Global Surgery Short Course.

Your E-Mail Address

Title

Last name

First name(s)

Preferred name

Gender

Male

Female

Other

Date of birth

/ /

Contact address

Phone number

Country of birth

Nationality

Include all nationalities

Country of current residence

If you are not a UK or EU citizen, but you are currently living in the UK, do you have indefinite leave to remain status (which has been entered into your passport)?

Yes

If yes, please provide the date it was granted

/ /

Is English your first language?

Yes

Please enter any details of English Language proficiency tests that you have taken (TOEFL, IELTS, Cambridge CPE)

English is the language of instruction and students whose native tongue is not English must be sufficiently fluent in English to enable them to study without disadvantage. If your first language is not English, or if your first language is English but you are not a national of the UK, Ireland or a majority English-speaking country recognised by the UK Visas and Immigration (UKVI), you must supply suitable evidence that you have reached the relevant higher level of English proficiency before any offer of a place can be confirmed. In some circumstances the English language requirements may be waived. Further details can be found on the University of Oxford website: https://www.ox.ac.uk/admissions/graduate/applying-to-oxford/application-guide?wssl=1#content-tab--3

Please enter your highest qualification

Current job title

(Or most recent job title)

Current employer

(Or most recent employer)

Dates of employment

Do you wish to apply for a bursary?

Yes

Please provide a brief statement explaining why you require a bursary. (under 250 words)

Funding is prioritised for delegates from LMICs.

Invoice details: Name, email and address

Statement of interest

Please write a statement explaining why you wish to take this course, your interest/experience in the area of Global Surgery, and how you hope to progress in this field after taking this course. (Under 500 words)

Please upload a copy of your CV

We're processing and storing the information you give us in accordance with the University's Staff and Student Privacy Notices.

Any questions about this form? Contact us at globalsurgery@nds.ox.ac.uk

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Application form