IMG SOS APPLICATION FORM IIIIIIIIIIIIIIIIII Name* First Last Gender*MaleFemaleNon-binaryEmail:* Phone*Address* City State / Province / Region Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands What describes your situation best?* You have not started You passed the AMC You are not an IMG You are a RACGP trainee You are a RANZCP trainee You are an ACEM trainee You are a RACP trainee You are a RANZCOG trainee You are on a pharmacy pathway Other What university did you graduate from?* Please give hints about your work experience, any courses you've taken before and past exam attempts if any*Which course are you interested in?*AHPRA PenaltyAMC ClinicalAMC MCQFACEM – PrimaryFACEM – FellowshipFACRRMFRACGP (AKT / KFP)FRACGP (CCE/OSCE)FRACP – DWEFRACP – DCEFRANZCOG – WrittenFRANZCOG – OralFRANZCPPEPEA / CAAKTPESCIPharmacy KAPSPharmacy Oral中国 AMC MCQOtherWhich area?Adult RACPPaediatric RACPWhich examination provider?*ACRRMRACGPIMERWAVOther / UnsureWhat are the 3 main difficulties in your exam preparation?*What will happen if you don't pass the exam?* On a scale of 1-10, how serious are you in your study and achieving your ultimate goals?*12345678910How would you feel if you passed the exam because you'd taken a course with us?* If our course has made you ready for the exam, how likely will you recommend us to others?* What are the features of our courses that are important to you?* The qualification and knowledge of the tutor The option to start the course soon The option to take the course from home The one-on-one format The high success rate The focus on the important bits and pieces of the exam The attached services such as paper work support or peer support The online material Preferred session times (AEST):* 7:00 am – 5:00 pm Weekdays 5:00 pm – 12:00 am Weekdays 7:00 am – 5:00 pm Weekends 5:00 pm – 12:00 am Weekends Any time Indicative time windows only. Exact session times and durations will be discussed directly with the tutor(s). Have you booked your exam? If yes, on what date?* When do you wish to start the course?* How did you find us?*AMC WebsiteGoogle adsInternet searchFacebookYouTubeFriend/ColleagueAustralian DoctorRACGPACEMRANZCPAMARDNRWAVGPRAMedicare LocalLinkedInEmail campaignPrevious course or webinarOther course providerImmigration agentOtherNotes or comments CAPTCHA