EmailMe Form - Application Form

Please, complete this form so that we can contact you via email and process your application. Thank you. (Rogamos, rellene este formulario para que podamos ponernos en contacto con Usted y gestionar su solicitud. Gracias.)

First Name / Nombre *

Last Name / Apellidos *

Pronouns

Date of birth

MM / DD / YYYY

Nationality *

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

Mobile Phone

Email *

Email (confirm)

How did you learn about the Barcelona Global Health Summer School?

Education

Work, volunteer or IFMSA background

Languages

I have a sufficient level of English to follow this course *

Yes, I have an advanced level of English

No, I do not have an advanced level of English

Why are you interested in attending the Barcelona Global Health Summer School?

What do you expect to learn?

How do you plan to apply the acquired knowledge?:

I understand that if my application is not complete and accurate it will not be considered. I understand that the course may be cancelled if numbers of participants are insufficient *

Yes

Your personal data will only be used by the Fundación Privada Instituto de Salud Global Barcelona (ISGlobal); CIF: G65341695; Postal address: Carrer Rosselló, number 132, 7th floor, 08036 Barcelona; Email: lopd@isglobal.org.

We collect and process the personal data you provide in this form for the sole purpose of registering the data of the person attending to the International Spring School on Global Health 2022 in order to be able to communicate information relative to it or make the administrative procedures that may arise.

We can only process your personal data with your consent, and it will be retained only as long as you do not withdraw consent.

You can exercise all your rights under current data protection regulations, including the right to access, correction, objection, erasure, portability and restriction, by writing to the Data Protection Officer (lopd@isglobal.org), attaching a copy of your national identity document or equivalent.

You have the right to withdraw your consent at any time. Withdrawal of consent does not affect the lawfulness of processing based on consent before its withdrawal. If you do not agree with the manner in which ISGlobal handles your data or you consider that your rights have been infringed, you can file a complaint at any time with the Spanish Data Protection Agency (www.aepd.es – C/ Jorge Juan, 6 de Madrid).

Personal Data *

By clicking the SUBMIT/SEND button (below) I acknowledge that I have been appropriately informed and that I consent to the processing of my personal data for the stated purpose.