Trainee Form

ع ع ع

Request for Training Internship/Summer Training/Practicum for Non-Physicians

Student's Information

Gender:

Male
Female

Nationality:

Saudi
Non-Saudi with Saudi Mother

Date of Birth (Gregorian):

Title:*

Academic Qualification:*

Out of:

4
5
100

Transcript:*

National ID:*

University Approval Letter:*

Training Information

Training Site:

Training Type:*

University:*

Training Area*	Rotation*	Training Start Date*	Training End Date*

Other: Training Area	Rotation	Training Start Date	Training End Date

University Coordinator Information

I hereby confirm that the information furnished above is true, complete and accurate to the best of my knowledge & belief. I allow KFSHRC to contact me via any of the contact details provided above.