ALBERTA INTERNATIONAL MEDICAL GRADUATE ASSOCIATION     

 

        

APPLICATION FORM                              

Surname _________________________________________
Given Name _________________________________________
Street Address _________________________________________
Apartment/Unit/Suite Number _________________________________________
City _________________________________________
Province _________________________________________
Postal Code _________________________________________
Email _________________________________________
Home Phone _________________________________________
Work Phone _________________________________________
Fax _________________________________________
Degree from _________________________________________

    
Please, print this application form and mail it to :

Alberta Network of Immigrant Women.

205-1409 Edmonton Trail. NE T2G-3K8

 Calgary-Alberta  Canada

 

Cheque should be made payable to:

 Alberta International Medical Graduate Association

AIMGA