Mock Candidates for 2025.1 Fellowship OSCE
Please fill out this form to express your interest in the above role.
Name
*
First Name
Last Name
ACEM ID
*
Phone Number
*
Your Email
*
Are you a current ACEM Fellow?
*
Yes
No
You must be an ACEM Fellow to participate in this event.
Date Fellowship obtained
*
-
Day
-
Month
Year
Date
Have you participated as a mock candidate previously?
*
Yes
No
Which days are you available?
*
Tuesday 18 March
Wednesday 19 March
Thursday 20 March
Friday 21 March
What is the maximum number of days you would be interested in attending as a mock candidate?
*
1
2
3
4
Any additional comments?
Submit
Should be Empty: