Online Registration Form

Instructions
1. Internship program is not restricted to pre-medical students
2. Please complete all sections and attach any additional information, if required
3. Your application and personal information will be kept confidential

Section: I

(Personal Information)

Name
Address
Landline NO
Mobile No

Emergency Contact Information

Name
Relationship
Contact No

Section: II

(Academic Record/ Achievements)

Current Class
Current School/College/University

Matric / O Levels

Qualification
School Name
Year
Marks Obtained
Total Marks
Grades
Major Subjects

Intermediate / A Levels (If Applicable)

Qualification
College Name
Year
Marks Obtained
Total Marks
Grades
Major Subjects

Graduation (If Applicable)

Qualification
University Name
Year
Marks Obtained
Total Marks
Grades
Major Subjects

Section: III

(Previous Internship Details If Applicable)

(1)

Organization
Year
Session
Speciality

Section: V

(Talent)

Please specify your personal talent:

Answer

Internship Slots (2 weeks, 3 weeks, 4 weeks & above)

O Levels / Matric (Registration Fees : 3000)

A LEVELS/FA/FSC/INTERMEDIATE (Registration Fees : 3500)

Note : (One week Eid holidays from 12th Aug to 16th Aug)

BACHELORS AND ABOVE Registration Fees : 4000 (additional 1000 for every added week)

Note: Nutrition Internships start from 1st of every month.

For Official Use Only:

✔ Food & Nutrition

✔ Clinical Nutrition

✔ Community Nutrition