UGMC Internship Request Form

Dear Intern, kindly complete this form to assist us in processing your request for internship at the Centre. Please note that submission of this form does not guarantee placement at UGMC. Thank you.

Please note, the cost of an Internship ID is GH₵ 50.

Personal Information

Fields marked * are required.

Full Name *

Contact Number(s) *

Active Email Address * Feedback will ONLY be received via this email. You will NOT receive phone calls when approved.

Gender *

Male

Female

Academic & Placement Details

Institution / School *

Course of Study *

Level *

Internship Period

Expected Start Date *

Expected End Date *

Duration

Head of Department (H.O.D) — Your Institution

H.O.D Name *

Contact Number or Email of H.O.D

Internship Letter * Upload up to 5 files: PDF or document. Max 10 MB per file.