CSC Funded IAP Program

**This application only accepts alpha characters.**

**Capitalize only the first letter of your first, middle and family name. Do not capitalize your entire name**

STUDENT INFORMATION

First Name

Family Name/Surname

Citizenship

Name as it appears on passport

Important: provide your personal email address below and not an email address shared with other people. Once accepted into the program we will be using email as our primary way to communicate with you so please check it often for updates.

Email Address

Birthdate

Phone number

Gender

Female

Male

Prefer not to disclose

Prefer to self-describe

Self-describe:

INSTITUTION INFORMATION

Name of Institution where you are currently enrolled

Name of the Institution Contact Person

Email address of the Institution Contact Person

Program/Major

Type of Program

5-year

6-year

7-year

8-year

ENGLISH LANGUAGE PROFICIENCY

English Language Proficiency (Check all that apply):

TOEFL

IELTS

None

Other

Please specify

HOW DID YOU HEAR ABOUT US

How did you hear about this program (Check all that apply)?

Please specify

EXPERIENCE

Please describe your overseas study experience(s) if you have any (200 words or less). If you do not have any, go to the next question.

Please list your expectations for this program and explain how the program will benefit your future study (250 words or less).

PAYMENT

Who will be paying for you to attend the course (Please check one)?
Note: A link to where and how you can pay will be sent to you in our email confirming our reception of your application.

Self

Institution

Combination of self and institution

PROTECTION OF PRIVACY

The personal information requested on this form is collected under the authority of the Alberta Post‑Secondary Learning Act and the Alberta Freedom of Information and Protection of Privacy Act for authorized purposes including admission and registration; administration of student records; consideration for scholarships and awards; and provision of student services. Personal information may be disclosed to academic and administrative units according to University policy; alumni relations and fundraising upon graduation; university planning and research in accordance with federal and provincial legislated reporting requirements; information sharing agreements; and to contracted service providers as required.

For further information on the use and disclosure of personal information, please contact the Young Physicians Program at ypp@ualberta.ca.

Why UAlberta

How to Apply

Tuition + Scholarships

Events

Support + Advising

CSC Funded IAP Program

Are you logging in to review/continue a current application for admission or have applied to the University of Alberta previously and have an existing Launchpad account?

Are you a previous or continuing University of Alberta student that does not have an existing Launchpad account?

Are you applying to any of the following Professional Programs?

Are you studying or have completed any education in Alberta?

CSC Funded IAP Program

Are you logging in to review/continue a current application for admission or have applied to the University of Alberta previously and have an existing Launchpad account? YesNo

Are you a previous or continuing University of Alberta student that does not have an existing Launchpad account? YesNo

Are you applying to any of the following Professional Programs? YesNo

Are you studying or have completed any education in Alberta? YesNo

Are you logging in to review/continue a current application for admission or have applied to the University of Alberta previously and have an existing Launchpad account?

Are you a previous or continuing University of Alberta student that does not have an existing Launchpad account?

Are you applying to any of the following Professional Programs?

Are you studying or have completed any education in Alberta?