Application Form

Apply now to one of the most exciting shadowing abroad program, today!

First Name

Last Name

Date of Birth

Gender

Pronouns

Phone / Area code

Permanent Address

City

State

Zip Code

Country of residence

Citizenship

How did you hear about Philotimo Med Abroad Experience?

Today's Date

What's your present College or University?

Years of study?

Intended Major

What's your current GPA?

Do you speak any other language besides English? If yes, include which one(s)?

Is this your first time away from home?

Do you have a valid passport?

Six months of remaining validity recommended

Parent/Guardian Contact Email

Emergency Contact Number

Do you have Covid Certificate card

Do you have any dietary restrictions. If so, please list them.

Do you have allergies? If so, please list them.

Do you take medication(s)? If so, please list them.

In which month(s) are you interested in attending?

January February March April May June July Aug September October November December Not sure

Desired Shadowing Program length?

One-week - Starting at $2500 (25+ hours of shadowing ) Two-week - Starting at $3500 (50+ hours of shadowing ) Three-week Starting at $4500 (75+ hours of shadowing) Four-week Starting at $5500 (100+ hours of shadowing Longer than 4 weeks - varies

Desired internship program

PA - Medical Nursing Dental Pharmacy Volunteer

what type of healthcare career are you interested in pursuing?

Kindly provide a brief description of your interest in the Philotimo Internship and elaborate on how your participation in the program aligns with your long-term interests in medicine. (Minimum 200 words).

Kindly provide a brief description of how does Philotimo Program align with your long-term goals?

Please provide a detailed explanation of any service, volunteer, or leadership experiences, particularly meaningful (200 words).

Will you submit a clear copy of the front pages of your original passport? (photocopies or scans of photocopies are not allowed. A very clear scan of the original is ideal). NOTE: Please make sure expiration is at least 6 months beyond the approximate end date of the program end.

Will you submit a copy of your transcript (scan or e-copy acceptable) at the time of application?

Upload Passport

Upload Transcript

Upload Medical records

Upload other document

Our team understands that funding can be a challenge, and we're here to help you find a program that fits your budget and fundraising solutions that fit your schedule. We're committed to working with you to make your participation with Philotimo possible, and we're happy to assist you in any way we can. Can you share with us how you plan to fund your participation? We're here to support you and find the best solution for your needs.

Do you understand the Philotimo Med Abroad Program Director reserves the right to cancel the application of any student who, before the program’s starts, fails to comply with the terms and conditions governing the program

Do you agree and understand that after we review your suitability and accept you into our program, you will need to pay a deposit of $500 to confirm your place. The remaining balance of your Program Fee (excluding your initial $500 deposit payment) will be due no later than 60 days before your internship start date.

Please submit a photocopy of the first page of your passport with this application and other listed documents. If you are currently in the process of applying for one, make sure you submit a photocopy as soon as you receive your passport. If you don’t have a passport yet, apply for one immediately.

Please make sure that your passport is valid for at least six (6) months after the return day of the trip.

Please note: The program director reserves the right to cancel the application of any student who, before the program’s departure, fails to comply with the terms and conditions governing the program.

We may request your official or unofficial transcripts. If you don’t have a college GPA (you’re in high school or a first-semester freshman) just use your high school GPA or your college midterm GPA, whichever is most recent.
I acknowledge that Philotimo Med Abroad Experience is not responsible for making air travel arrangements (round-trip).
As a participant in one of our Philotimo Med Abroad Experience programs, you are asked to complete the necessary forms which include:
• Medical information • Emergency medical care authorization • Covid certificate card • Personal statement and short answers

If you have any questions or need further clarification, please don’t hesitate to contact us at admissions@philotimomedabroad.org or your program director.