FELLOWSHIP APPLICATION

Excited to join our fellowship program?
Fill in your personal details in the form below and upload all the required documents at the bottom of the page to start your journey with us!

First name*

Last name*

Email address*

Phone number*

One sentence explaining your personality/ideas as a fellow*

Message*

UPLOAD YOUR
DOCUMENTS

Your CV

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A picture of yourself

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Two letters of recommendation

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Your motivation letter

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Medical degree

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Plastic Surgery degree

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I will send a 5 minute videoclip performing a wound closure via Wetransfer to boekhouding@coupurecentrum.be. If you don't send this video, your fellowship will not be considered.

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FELLOWSHIP APPLICATION

FELLOWSHIP APPLICATION

UPLOAD YOUR DOCUMENTS

UPLOAD YOUR
DOCUMENTS