Medical Student Representative Application
Please complete all three sections to apply for the role of medical student representative role on ASiT Council. Details of the role can be found on the ASiT website (www.asit.org).
Background Details
Please note you must be an ASiT member to apply for this role
ASiT Membership Number: *
Your answer
Full name: *
Your answer
Year of study: *
Your answer
University: *
Your answer
Anticipated year of graduation: *
Your answer
Email address: *
Your answer
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