MASTER'S DEGREE AND PH.D. DEGREE IN MEDICAL,
DENTAL AND HEALTH SCIENCES PROGRAM

Mexico City

_____________, 2002

 

RE: Application to participate in
the competitive selection process

 

Dr. Luis Felipe Abreu H.
Program Coordinator

 

 

I, the undersigned, ________________________________________________ am pleased to inform you
  (first name, middle name, father's surname, mother's surname)  

that, after reviewing the entrance examination notice, I consider myself to be a candidate pursuant to the requirements stated and wish to be considered to take part in the competitive selection process to be admitted to the Program.
I therefore ask you for your authorization to take the English language reading comprehension examination as part of the first phase of the process.

I attach my registration application and the documents requested for this initial phase.


Thank you in advance for the attention paid to this request and I hope to receive a favorable response.

 

 

SINCERELY
(candidate's signature)

Approved by
Person in charge of the Operational Unit
or Main Field of Study
Authorization to take
English examination

 

 

 

REGISTRATION APPLICATION FORM FOR THE

SELECTION PROCESS

 

GENERAL DATA


Name__________________________________________________________________________________

Father's surname, Mother's surname, Name(s)

Address_________________________________________________________________________________

Street Number District Town Zip Code

Home telephone no. ______________________ Office telephone no.._________________________________

e-mail____________________________________________

Date of birth_________________________________

BACHELOR'S DEGREE DATA

Name of bachelor's degree: __________________________________ Has the degree been awarded Yes No

Institution where it was taken: ________________________________ Average obtained____________

If you have not yet finished your bachelor degree

How many subjects do you still need to study?______________  
Have you done your social service?
Yes
No
Have you done your internship?(medicine)
Yes
No
Have you finished your thesis?
Yes
No


SPECIALTY DATA

Name of Specialty: ________________________________ Has the diploma been awarded? Yes No

Institution where it was taken: _________________________________ Average obtained ____________

If you have not yet finished the specially, which year are you registered for?__________________________________


MASTER'S DEGREE DATA

Name of Master's Degree: _________________________________ Has the degree been awarded? Yes No

Institution where it was taken: _________________________________ Average obtained ____________

If you have not yet finished your master's degree

How many subjects do you still need to study? ________________________  
Have you finished your thesis?
Yes
No

 

Degree you wish to take: Master's Degree( ) Ph.D.( )

Field of knowledge you wish to take:

Medical Sciences( ) Dental Sciences ( ) Health Sciences( )