(A) Personal Particulars

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(B) Others

YEAR AND DEGREES/DIPLOMAS AWARDED
*Please enclose a copy of your CV
Click or drag files to this area to upload. You can upload up to 3 files.

(C) Entry Criteria

Must fulfill all of the following

DECLARATION

I hereby make an application for the Collegiate Membership of the College Programme and declare that the information stated in this application is true and correct and I have not withheld/distorted any facts. I confirm and consent to College of Family Physicians Singapore collecting, using and/or disclosing my personal data which I have provided, including the NRIC number.

Please send the following:

1. Completed application form (with photograph attached) together with a cheque payment of S$5,505.34**(inclusive of 7% GST), make payable to 'College of Family Physicians Singapore'
2. A curriculum vitae
3.Certificates of your academic qualification - Med (Internal Medicine)/MRCGP(UK)/MRCP(UK) & GDFM
4. A letter of good standing from someone with MCFP(S) or above

The application, cheque payment and all required documents must be received by 7 June 2019 (Friday)

Censor-in-Chief
Collegeof Family Physicians Singapore
College of Medicine Building, 16 College Road #01-02, Singapore 169854


*Successful candidates will be provided with the use of the academic gown during the Convocation Ceremony on 23 November 2019 (Saturday). The successful candidate and one guest will also be invited to the Convocation dinner.

**Upon successfully passing the Assessment, the candidate will need to pay an additional $1,402.95 (S$374.50 (inclusive of 7% GST) Entrance fee and $1028.45 (inclusive of 7% GST) initiation fee).

FOR OFFICIAL USE ONLY