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Personal data
   
     
First name (Latin)*
 
Surname (Latin)*
 
First name (Arabic)
 
Surname (Arabic)
 
     
Sex*
  Male Female
Birth date
  . . ( Example: 25 / 01 / 1970)
Birth place
 
Marital status
  single married divorced widowed
     
Citizenship (1)
 
Citizenship (2)
 
     
Contact data
   
     
Street / No.
 
Postcode / City
 
Country*
 
     
E-mail address*
 
Tel. no.
  Country Code / Area Code / Call no.
00
( Example: 49 / 030 / 456789)
Fax no.
  Country Code / Area Code / Call no.
00
( Example: 49 / 030 / 456789)
Mobile no.
  Country Code / Area Code / Call no.
00
( Example: 49 / 030 / 456789)
     
Medical career
   
     
Approbation year
 
Speciality*
 
Medicine
Dentistry
Pharmacy
Nursing
Other
Not listed
Career start*
 
     
Medical institution
   
     
Institution name
 
Institution type
 
University hospital
Hospital
Surgery
Other:
Training opportunities
 
Postgraduate
Fellowship
Speciality
     
Availability for duty
   
     
Maximum duration*
  Not available 1 week 2 weeks 3 weeks 4 weeks More than 4 weeks
Regions
 
Gaza Strip
West Bank
Lebanon
Jordan
Syria
Other
Preferred months
 
1 Januray
2 February
3 March
4 April
5 May
6 June
7 July
8 August
9 September
10 October
11 November
12 December
No preferences
Preparation period
  Week(s)
   
Miscellaneous
   
     
Language skills
 
Albanian
Arabic
Basque
Belarusian
Bulgarian
Catalan
Croatian
Czech
Danish
Dutch
English
Estonian
Finnish
Flemish
French
German
Greek
Hebrew
Hungarian
Icelandic
Irish
Italian
Latvian
Lithuanian
Luxembourgish
Norwegian
Polish
Portuguese
Romanian
Russian
Scottish Gaelic
Serbian
Slovak
Slovene
Spanish
Swedish
Turkish
Ukrainian
Welsh
Special skills
 
Hobbies
 
     
Notes
   
   
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