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This is not an application form. If we wish to invite an application, we will confirm this to you. If you are unsure about any part of the enquiry process, please contact the Postgraduate Medicine Administrator on 01244 513860 or medicine@chester.ac.uk

1) Personal Information
(NB It is very important that you are consistent in the spelling and order of your names)
(This must be a street address rather than a PO Box number to enable us to contact you quickly):
2) Details of your Qualification (MBBS or equivalent) and post-qualification experience.
Detail of Internship:
(please provide name of the speciality start date, end date of each speciality with the name of the supervising consultant):
Post-internship experience
Please provide the Speciality name, Start Date, End date, Institute & Supervising Consultant for each post:
3) Result of the British Council International English Language Testing System (IELTS)
Please fill in your results in each box below:
If you think you may be exempt from the IELTS please contact the International Office after consulting the exemption criteria on the GMC website at: http://www.gmc-uk.org/doctors/registration_applications/24986.asp
4) Funding
Please provide details:
5) Career goal