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Application for International Medical Fellowship

    The following documents must be submitted before you can be approved:

    • Cover Letter and Resume - Please include your international and/or medical experience (if any), and indicate if you are interested in a particular trip
    • A short video of yourself telling us why you would be a great asset to our team and how you heard about AfS.

    Applicant Name


    Applicant Address


    Additional Information

    Birth Date (required)

    Gender as shown on travel document

    Passport Number

    Passport Expiry

    Nationality

    School Name (if applicable)

    Current School Year (if applicable)

    Do you speak any languages besides English? (Indicate level of fluency)

    There will be times when you will be asked to wear an Alliance for Smiles t-shirt or polo shirt that will identify you as a team member.
    Shirt Size (in unisex size)

    Please describe your current health, including any medical conditions we should be aware of.


    References


    Personal Reference [non-family member; someone who has known you for at least 5 years]

    Name

    Title

    Phone

    Email

    Notes


    Professional Reference

    Name

    Title

    Phone

    Email

    Notes


    Parent or Guardian


    Documentation

    The following documents must be submitted before you can be approved:

    • Cover Letter and Resume - Please include your international and/or medical experience (if any), and indicate if you are interested in a particular trip
    • A short video of yourself telling us why you would be a great asset to our team, and how you heard about AfS

    Upload Documents Here: www.dropbox.com/request/vXRTqLbm7NIfQfVL1xKR

    If you don't have the documentation ready now, you may submit it later at the above link. You will also receive this link in an email, once you hit SUBMIT below.


    Once you have completed the application and uploaded all files that you wish to, please agree to the terms and hit the SUBMIT button below.

    I fully understand that any significant misstatement in or omissions from this application will constitute cause for denial of my application for affiliation with Alliance for Smiles. I hereby affirm that the information I have furnished to Alliance for Smiles on this application and in any accompanying document is true and complete to the best of my knowledge.

    Do you agree to the above terms?