Registration for 2024

Clerkship in Australia - University of Wollongong

Applicants must be enrolled either at the University of Vienna or at the Medical University Vienna. Student-ID must be a 7-digit number. For SIP 1, 2 and 3 please specify relative points (given in percent of total points) reached as indicated in the respective form ("Fragenausdruck", see image). Applicants need to upload a CV in English (maximum filesize 2MB, pdf preferred), otherwise registration cannot be completed. Items marked with * are required. Please enter your data carefully, there is no post-check page.

First name:	*
Family name:	*
Street:	*
ZIP:	*
City:	*	SIP 1:	*
Country:	*   AfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua / BarbudaArgentinaAscensionArmeniaAustraliaAustriaAzerbaijanAzoresBahamasBahrainBaker IslandBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia HercegovinaBotswanaBrazilBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiByelorussiaCameroonCanadaCantonCayman IslandsCentral African RepublicChadChannel IslandsChileColombiaComorosCongoCosta RicaCote D\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEnderbury IslandEquatorial GuineaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHowland IslandHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJapanJarvis IslandJohnston IslandJordanKampucheaKazakhstanKenyaKingman ReefKirghiziaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesotoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMadeira IslandsMalawiMalaysiaMaldivesMaliMaltaManua IslandMartiniqueMauritaniaMauritiusMayotte IslandsMexicoMidway IslandsMoldova RepublicMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNeth Antilles ArubaNetherlandsNew CaladoniaNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPanamaPapua New GuineaParaguayPeoples Republic ChinaPeoples Republic Korea (North)PeruPhilippinesPitcairn IslandPolandPortugalQatarRepublic of Korea (South)Reunion IslandRomaniaRussiaRwandaSand IslandSao Tome / PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSoloman IslandsSomaliaSouth AfricaSpainSri LankaSt Christopher NevisSt Croix IslandSt HelenaSt John IslandSt LuciaSt Thomas IslandSt Vincent GrenadineSudanSurinameSwain\'s IslandSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad / TobagoTristan da ChunaTrust Territory PacificTunisiaTurkeyTurkmenistanTurks / Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWake IslandWallis / Furtuna IslandsWest IndiesWestern SamoaYemenZaireZambiaZimbabweother	SIP 2:	*
Phone:	*	SIP 3:	*
Phone in case of emergency:	*
Fax:	*	Start date (first choice):	*   Day---01020304050607080910111213141516171819202122232425262728293031     Month---010203040506070809101112    2024
e-mail:	*	Start date (second choice):	*   Day---01020304050607080910111213141516171819202122232425262728293031     Month---010203040506070809101112    2024
Date of birth:	*   Day---01020304050607080910111213141516171819202122232425262728293031     Month---010203040506070809101112     Year---2005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963	I would like to perform my clerkship together with:
Gender:	*   malefemaleinterdiversother		*
Nationality:	*   AfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua / BarbudaArgentinaAscensionArmeniaAustraliaAustriaAzerbaijanAzoresBahamasBahrainBaker IslandBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia HercegovinaBotswanaBrazilBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiByelorussiaCameroonCanadaCantonCayman IslandsCentral African RepublicChadChannel IslandsChileColombiaComorosCongoCosta RicaCote D\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEnderbury IslandEquatorial GuineaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHowland IslandHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJapanJarvis IslandJohnston IslandJordanKampucheaKazakhstanKenyaKingman ReefKirghiziaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesotoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMadeira IslandsMalawiMalaysiaMaldivesMaliMaltaManua IslandMartiniqueMauritaniaMauritiusMayotte IslandsMexicoMidway IslandsMoldova RepublicMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNeth Antilles ArubaNetherlandsNew CaladoniaNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPanamaPapua New GuineaParaguayPeoples Republic ChinaPeoples Republic Korea (North)PeruPhilippinesPitcairn IslandPolandPortugalQatarRepublic of Korea (South)Reunion IslandRomaniaRussiaRwandaSand IslandSao Tome / PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSoloman IslandsSomaliaSouth AfricaSpainSri LankaSt Christopher NevisSt Croix IslandSt HelenaSt John IslandSt LuciaSt Thomas IslandSt Vincent GrenadineSudanSurinameSwain\'s IslandSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad / TobagoTristan da ChunaTrust Territory PacificTunisiaTurkeyTurkmenistanTurks / Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWake IslandWallis / Furtuna IslandsWest IndiesWestern SamoaYemenZaireZambiaZimbabweother
Student-ID:	*	Select file for CV:

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