Rural Clinical Elective Application Form
Image of the university logos.
Submission Time Frames
Important Notice for Elective Placement Period
Period Submission Commencement Submission Deadline Review Period
July/August 2020 01-Nov-19 31-Dec-19 January 2020
December 2020/January 2021 01-Feb-20 30-Apr-20 July 2020
test 02-Jun-18 02-Jun-20 1

Please note that we will not assess applications received outside of the above timeframes.
Personal Details

Please ensure you prefix the number with your country code.


Students who are offered a placement will be charged a non-refundable placement fee which is paid online once details are confirmed:

  • International medical students: $1,000.00
  • Australian and NZ medical students: $220.00
  • UWA & Notre Dame Fremantle medical students: No fee
Student’s Knowledge of English

Documents required to be uploaded when submitting this Application:

  • A copy of the identification pages of your passport endorsed by your Faculty representative (not applicable for UWA or Notre Dame Fremantle medical students);
  • Proof of proficiency in written and spoken English — if not your first language, or your course is not taught in English, IELTS or TOEFL or a statement from your university. You must be able to understand, write and speak English competently;
  • A letter from your Faculty confirming your student status and level and in good standing;
  • Your current CV;
  • Any additional documentation you deem appropriate to submit.

Tip! Hold the CTRL or ⌘ to select multiple documents.

By submitting this form, you:

  • agree that the specified fees are non-refundable; and
  • have supplied the correct information in the form; and
  • attached the required identity and eligibility documentation.