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Candidate Recruitment Form - The Harvard Medical School's Polish Clinical Scholars Research Training Program

  1. Remember that the form must be completed in ENGLISH.
  2. Remeber to apply documents in language from which they were created. There is no need to translate original documents prepared in Polish into English.
  3. Provide up-to-date contact details that will allow us to contact you. Avoid giving details to the secretariat or registration office - in such a situation we may have a problem with contacting you.
  4. Each file name should end with ".pdf" (e.g., "filename.pdf"). File names must not contain spaces.Please make sure that the file is saved in PDF format before uploading. Please do not use any other special characters in the file name.
  5. If you copy/paste information from another document, check that everything has been copy/paste correctly.

Registration form for The Polish Clinical Scholars Research Training - 3rd edition Personal Information:
in XXXX format
in XXXXXXXXX format (9 numbers)
Professional Background and Qualifications:
1. Are you a reasercher? * Wymagane pole
2. Have you graduated from a clinical research area, health sciences or life sciences? * Wymagane pole
Dodaj If YES, enter the name of the major and attach a copy of the original diploma:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Diploma.pdf”
3. What is your highest academic title obtained? * Wymagane pole
4. Letter of recommendation * Wymagane pole
Dodaj If YES, attach a letter from your supervisor/manager:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Letter.pdf”
 Scientific Publications and Impact:
5. Scientific publications * Wymagane pole
(Enter max. 3 publications and attach pdf files with title, authors, IF and journal name, then calculate the average IF of all 3 publications):
Dodaj Publication 1:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Publication1.pdf”
Dodaj Publication 2:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Publication2.pdf”
Dodaj Publication 3:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Publication3.pdf”
Certificates of training and postgraduate studies in clinical trials:
6. Have you completed training courses in clinical research? * Wymagane pole
If YES, enter the name of the course and attach a copy of the original certificate (Enter max. 3 names of training)
Dodaj Copy of the original certificate:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Certificate.pdf”
Dodaj Copy of the original certificate:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Certificate.pdf”
Dodaj Copy of the original certificate:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Certificate.pdf”
7. Have you completed postgraduate training in clinical trails? * Wymagane pole
Dodaj If YES, enter the name of the course and attach a copy of the original diploma:
pdf
*Each file should contain a name with “.pdf” at the end, e.g. “Diploma.pdf”
English Language Proficiency:
8. Language skills: * Wymagane pole
 Candidate Acknowledgments and Declarations:
Candidate's Statement * Wymagane pole
I declare that all the information I have provided is true and I am aware that its untruthfulness may result in the rejection of my candidacy.
 .
Candidate's Statement * Wymagane pole
I declare that I am not a citizen of the United States of America and I am not participating in any educational program provided by the Government of the United States of America.
 .
Attention * Wymagane pole
I understand that the documents confirming the completion of studies, training and other attachments required in the form are necessary for the verification and scoring of the candidate and that the absence of attached documents will result in the lack of points or the failure to consider the criterion in the recruitment process.
 .
Candidate's Statement * Wymagane pole
I have read the content of the information clause regarding the processing of personal data.

Information Clause
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