Request edit access
Registration for the EPSA Humanitarian Mobility Project
Dear Applicants,

Thank you for your interest in the EPSA Humanitarian Mobility Project. Your application will be evaluated based on your motivation and experience with the answers provided in this form.
Please, be as honest and as precise as possible. Thank you for your cooperation! Do not hesitate to contact EPSA Mobility Coordinator If you have any question!

Please do not answer questions with more than 150 words. After application period selected candidates will be asked to sign the Liability Waiver form.

Baran Arslan, EPSA Mobility Coordinator 2018-2019

mobility@epsa-online.org

* Required

Email address *
Email Address *
Your answer
Name Surname *
Your answer
Country *
Your answer
University and Year of Study *
Your answer
Adress *
Your answer
Telephone Number(with country code) *
Your answer
Emergency Contact *
Your answer
Passport Validity *
MM
/
DD
/
YYYY
Passaport /ID Number* *
Your answer
EPSA Membership *
Required
Do you need an invitation letter for participating in this project?* *
What is your main motivation to participate in this project? *
Your answer
What is your opinion on Refugee crisis in Europe?What do you think about the role of healthcare students in this issue? *
Your answer
Do you have any special skills that you can teach like painting, teaching English etc.? *
Your answer
Have you ever taught children? *
Your answer
Do you have allergies?*Please specify it. *
Your answer
I give my consent to EPSA (European Pharmaceutical Students' Association) to process the data I have provided for the purpose of contact in regards to and promotion of the Humanitarian Mobility Project. I also give consent for my personal data to be available on the EPSA website for the aforementioned purpose. The provided data will be deleted upon my disengagement from the activity I am applying to OR when deemed appropriate by EPSA. Alternatively, the provided data shall be deleted immediately upon my request. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of EPSA. Report Abuse - Terms of Service