Summer Enrichment Program: PCEP

Student Information

Prefix

Your Name *

Date Of Birth *

Gender (M/F) *

Citizenship *

Street Address 1

Street Address 2

City *

Country of Residence *

Telephone (area code + number)

Mobile (area code + number) *

Email *

Upload a Copy of Your ID or Passport *

Education

Country of High School *

Expected year of graduation *

Type of the Certificate / Diploma

Name of School Principal, Counselor or Teacher *

E-mail *

Upload Your Latest Transcript *

Father's Information

Full Name *

Mobile (area code + number) *

E-mail

Occupation *

Mother's Information

Full Name *

Mobile (area code + number) *

E-mail

Occupation *

Personal Statements

Question 1: Why are you interested in participating in the Summer Enrichment Programs at Weill Cornell Medicine-Qatar? *

Question 2: What are your hobbies, activities, or areas of interest, and why? *

Question 3: Why are you interested in pursuing a career in medicine? What steps have you taken to learn more about the medicine profession? *

Parental Consent *

I hereby confirm that I received my parent/ guardian's consent to participate in Qatar Summer Enrichment Programs selected above and that I will be providing a signed written consent from my parent/guardian upon selection.

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