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IMEPH Sign-up

Apply for the four-week International Medical Elective in Public Health (IMEPH) at Ensign Global University. Complete the form below, then continue to payment to secure your place.

1Complete the form
2Continue to payment
3Receive confirmation

1 Background information

Surname * First name * Middle name Nationality * Gender * Date of birth * Email *Your confirmation will be sent here. Phone number * WhatsApp number University / medical school

2 Project work

Will you be working on your thesis as part of your programme? *

Yes No

Area of thesis project * Please specify the area * Thesis topic * Questionnaire (optional) Dataset (optional) Upload documents relevant to your thesis. PDF, Word, Excel, CSV, SPSS (.sav), Stata (.dta) or ZIP · max 10 MB each.

3 Your expectations Please describe your expectations for the programme * 0 / 50 wordsNot more than 50 words.

I confirm that the information I have given is correct, and I agree to Ensign Global University storing and using it to process my application for the International Medical Elective in Public Health.

After you select “Continue to payment”, your application is saved and you are taken to our secure Paystack page to pay the programme fee. Your place is confirmed once payment is received.

Fields marked * are required.

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