GEM Initiative Faculty and Volunteer Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

GEM Initiative Faculty and Volunteer Registration Form

The total war situation in Gaza has devastated healthcare and medical education in Gaza. Recognising the need for sustainable medical education and its role in the recovery of healthcare in Gaza, we started his collaborative initiative to support Gazan medical students and medical education in Gaza.

We need your help and we would like to invite you to complete this registration form which would allow us to work together more effectively towards this aim. Please feel free to volunteer for any of the other committees of your choosing.

Many thanks for your help and support.

Email *

Preferred Title *

First Name *

Surname *

Email address *

Phone number *

Clinical position (current) *

Town and country in which you work? *

Academic post if any

Educational posts or activities

Do you wish to be a member of (please include only three choices): *

Faculty Committee

IT Committee

Module Recovery and Design Committee

Assessment and Evaluation Committee

Clinical Placement Committee

Fund Raising Committee

Standards & Governance Committee

Media & PR Committee

Mental Health and Wellbeing Committee

Required

If you selected the Faculty Committee please state your specialty below:

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms