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1st Batch Registration 2027/2028 IFMSA SCORE Exchange

Full Name *

*Based on Passport

Place of Birth *

Date of Birth *

Gender *

Male
Female

Phone Number *

LINE ID *

Email Address *

Home Address *

Current Address *

Nationality *

Passport Number *

Passport Exp. Date

University *

*Example: Universitas Indonesia

Year of Enrollment *

*Enrollment in pre-clinical year

Desired month (between April 2027–March 2028) *

April
May
June
July
August
September
October
November
December
January
February
March

Access the latest post about 1st Batch SCORE Exchange at our Instagram (@scorecimsa) to learn about the available countries. Choose max. 3 (three) CATEGORY A countries, 2 (two) CATEGORY B country, 1 (one) CATEGORY C country, and 1 (one) additional optional country in YOUR DESIRED PRIORITY ORDER.

1st Country Preference *

2nd Country Preference *

3rd Country Preference *

4th Country Preference *

5th Country Preference *

6th Country Preference *

7th Country Preference (Optional)

ONLY IF YOU CHOOSE SWITZERLAND

If you choose Switzerland (8 weeks)

I acknowledge that choosing Switzerland (8 weeks) will automatically place it as my 1st preference, and my other country choices will move to 2nd, 3rd, 4th, and so on

I am willing to be placed in another country regardless of my choice *

Yes
No

Do you wish to take an English test from SCORE, or use your own certificate? *

I wish to take an English test from SCORE
I will use my own certificate

Do you apply for SCOPE Season 2027/2028? *

Yes
No

Permission & Agreement *

I have read the guideline (bit.ly/1stBatchSCORE2728) to this exchange program, pursuant to all the terms and regulations that apply. If I fail to follow set guidelines, I will accept disqualification.

Access all the template for required documents via (bit.ly/ApplicationPackageSCORE2728) then upload all of them also the optional ones within correct format

Upload your CV *

Rename as '[CV] Name_Univ_1.27.28.pdf' and upload here CV

Upload your Motivation Letter *

Rename as '[MotLet] Name_Univ_1.27.28.pdf' and upload here MotLet

[OPTIONAL] Upload your Immunization Card

Rename as '[Immunization Card] Name_Univ_1.27.28.pdf' and upload here Immunization Card

[OPTIONAL] Upload your Language Certificate

Rename as '[Language Certificate] Name_Univ_1.27.28.pdf' and upload here Language Certificate

Please send your payment for the application form to FAIZ NUR SULISTIAWAN Bank Mandiri 1560022014957 *

I have paid Rp250.000

Upload your Payment Receipt here *

Rename as '[Payment Receipt] Name_Univ_1.27.28.png' and upload here You can upload up to 1 files.

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Standing Committee on Research Exchange

Center for Indonesian Medical Students' Activities

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