Registration Closed

Ignite 2024: Summer internship program for school students aspiring to enter the medical profession.

Please complete this form to register for IGNITE 2024.

Kindly note: There are only limited number of seats for IGNITE 2024. We request previous participants to not apply again, so that we can provide opportunity for new participants in this innovative program.

* Required

Name *

Date of Birth *

Age *

Gender *

Class *

School *

Father's Name *

Mother's Name *

Address *

Phone number of guardian with whatsapp *

Phone number of guardian 2 *

Email id of Parent/Guardian *

FOOD REQUIRED? (For breakfast or lunch, the payment is to be made by the participant at the canteen payment counter before the meal; Tea/ coffee/ juice and snacks shall be provided twice a day and are complimentary.) *

If food required, preference is

Prefered cuisine for Breakfast

Any allergies *

Hobbies and Interests *

Why do you wish to enter medical profession to be a doctor ? *

Please upload a photograph of the school ID card of the student. Full name and class should be visible.