First Name:
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Surname:
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Date of birth:
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Place of birth:
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Address:
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Phone Number:


Mobile Number:


Email:
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University:


Year of attendance:


1. Why are you applying? Explain your motivation.


2. What do you expect from this experience?


3. How long would you like to stay in Kumba (Cameroun)? Which month/s do you prefer?


4. Describe your curriculum vitae.


5. Do you know anything about Tropical Medicine?


6. Have you any particular interest in some medical area?


7. Have you already been in a developing country?


8. Do you know any foreign language? Please send a certificate if you have one (a SISM-IFMSA one is appreciated).


9. Have you ever made any voluntary service experience? Which ones?


10. Would you like to take part into Medical Hygiene Education Program? Why? (explain your motivations in a few words)

---------- Only for Health Education applicants: -------------

11. Are you prepared to participate to the planned meetings (in Ferrara, every 15 days)? If not, why?

For the ones interested to participate to Health Education, the submition of the A.F. is required at least 3 months before the departure. The participation to the Health Education Program is exclusively allowed for students of 5th course-year (and up), specializing/attending doctors, and nurses in the last year of course, with fluent spoken English.

After the approval of the A.F., the students will receive documentation and didactic material to be studied. Subsequently, during the period before the departure, some meeting (4 or 5) will be organized for projecting and planning the educational activity that will be carried out during the mission. The applicants are required to attend these meetings (exception only on documented impossibility).
The number of students for the Health Education Program will be no more than 4-5 per group.

For the students chosen for the Health Education, all the advised vaccinations are mandatory.

The approval of the A.F. is under exclusive judgment of Kumba Project's Departures Committee and Scientific Committee.