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Medical and Nursing Student Electives
Application Form

If you're interested in applying for an elective or summer practice placement with our clinic, we will be happy to help you with your academic application and immigration requirements.

 

Please note that we only accept students from universities in Czech Republic, Hungary, Israel, and Poland.

As of October 2023, foreign students who apply for a summer practicum placement at CRMC can only be accepted if they obtain a clear police check in the country of their residence as well as a FAMA-enhanced background check in Canada. In addition, they must have been continuously resident in either Czech Republic, Hungary, Israel, or Poland for the 10 years preceding their application.

To start your application, please fill out the form below.

Please have the following documents in PDF format ready to attach to your application form below (click on underlined text to open the relative document):

Date of Birth of Applicant
Year
Month
Day
What is your status in Alberta?
Canadian citizen
Permanent resident of Canada
eTA holder

(students who are not Canadian citizens or permanent residents must apply for an eTA before flying to Canada, and their elective must be shorter than 16 weeks)

What are you studying?
Nursing
Nurse Practitioner
Medicine
What country do you study in?
Czech Republic
Hungary
Israel
Poland
Have you resided in the country you chose in the answer above for the past 10 years continuously?
Yes
No, I have spent part of the last 10 years in other countries apart from those four above.
No but I have lived in either Canada, Czech Republic, Hungary, Israel, or Poland in addition to the country I study in within the last 10 years
Date of Application
Year
Month
Day
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

You may use your mouse to sign inside the box, or you may choose to upload your signature as a file, or you may choose to type your signature. All three forms are legally accepted in Alberta.

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