Mentors Sans Frontières Application Form

There are a maximum of 8 places available per year on the Mentors Sans Frontières initiative.

Your application is subject to review by the Education Committee. You will be notified regarding the status of your application within three weeks of applying.

Should you have any questions regarding your application please contact the ESCP Secretariat.

Before you complete this form, it is important that you have all the information ready to upload and meet the following eligibility criteria:

Be a fully paid member of ESCP (i.e. full, trainee etc.) for a minimum of 12 months
Are a senior trainee, senior surgical registrar or junior consultant within the first five years of your career

Please read ESCP's Privacy Notice.

* indicates that this information is required

File extensions permitted to upload: jpg, jpeg, png, gif, pdf, doc, docx, txt, zip. Maximum file size 1MB.

Institution

Name of institution

Address

Country

Applicant

Personal details

Name of applicant

Email address

Phone number

Your qualifications and experience

All documents must be submitted at the time of application

Submit a letter of support from your supervisor / head of department confirming that you are a senior trainee, senior surgical registrar or junior consultant within the first five years of your career, and your CV (max one page only).

Upload your letter of support

Upload your CV (max 1 page only)