Student Scholarship Form

Student Scholarship

This online form is used to apply for complimentary registration for continuing medical education programs.
Students must be currently enrolled in medical, pharmacy or health sciences programs.
Failure to attend the program may result in disqualification from future scholarship opportunities and/or student membership

First Name

Last Name

Email

Name of CME Program or Conference

Name of Institution

Student ID Number

Program Name

Graduation Year & Month

City of Residence

Country

Upload proof of enrolment (photo of student ID, copy of registration. etc):

Maximum file size: 52.43MB

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Student Scholarship Form

Student Scholarship

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