Education

Send Application Form

  1. Home
  2. Education
  3. Send Application Form

Send Application Form

First Name Middle Name
Last Name Nationality
Gender
Date of Birth
Current Organization
Address
Desired Training Date
~
Department Desired Professor Name
Passport Phone Number
E-mail Fax.
Use of Dormitory
~
Comment (0/300)

Attachment

Attachment

Asan Medical Center needs your consent to the collection, use and provision of your private information to a third party as follows in accordance with Article 15, Section 1, No.1, Article 23, Section 1, No.1 and Article 24, Section 1, No.1 of the 「Personal Information Protection Law」.

Personal Information Collection·Use Consent

1. Purpose

Collection of Information for the operation of “Asan Medical Center International Visiting Scholars Program”

2. Collected Information

Personal Information : Name, Nationality, Current Organization, Photo, Address, Contact Details, Date of Birth, Gender, Medical Board License, Certificate of Specialty, CV, Academic Background, Certificate of Employment, Social Security Number

3. Retention Period

5years

4. Right to refuse the consent and disadvantages in case of refusal

You can refuse consent to the provision of the stated items, but please note that you cannot proceed the training program if you do so.

I consent to the collection and use of my personal information as the above.      

Personally Identifiable Information Collection·Use Consent

1. Purpose

Collection of Information for the operation of “Asan Medical Center International Visiting Scholars Program”

2. Collected Information

Personally Identifiable Information : Passport

3. Retention Period

5years

4. Right to refuse the consent and disadvantages in case of refusal

You can refuse consent to the provision of the stated items, but please note that you cannot proceed the training program if you do so.

I consent to the collection and use of my Personally Identifiable Information as the above.      

Sensitive Information Collection·Use Consent

1. Purpose

Collection of Information for the operation of “Asan Medical Center International Visiting Scholars Program”

2. Collected Information

Sensitive Information : Health Status

3. Retention Period

5years

4. Right to refuse the consent and disadvantages in case of refusal

You can refuse consent to the provision of the stated items, but please note that you cannot proceed the training program if you do so.

I consent to the collection and use of my Sensitive Information as the above.      

CAPTCHA