I agree with the terms stated above and overleaf.

This Rules Form is to confirm that the exchangee is aware of the responsibilities and regulations of the Clerkship.

The exchange student (filled in by exchange student):

FIRST NAME AND FAMILY NAME:...................................................................................................

ADDRESS:................................................................................................................................................

DATE of BIRTH:......................................................................................................................................

CITY/COUNTRY:....................................................................................................................................

NATIONALITY:.......................................................................................................................................

PHONE:.....................................................................................................................................................

PASSPORT N°:.........................................................................................................................................

e-mail:.........................................................................................................................................................

The host organization:

ORGANIZATION:..................................................................................................................................

CITY:..........................................................................................................................................................

PERIOD:.....................................................................................................................................................

COUNTRY:................................................................................................................................................

Hereby I compromise myself to:

· regularly attend the Clerkship for its whole duration;

· strictly follow all the instructions given by the department and the Local Committee;

· arrive the first day of the Clerkship, and never later than 3 days after the commencement of the Clerkship. If I fail to do so, and do not inform the Local Committee about it, the Clerkship is no longer guaranteed;

· insure myself before leaving my country. I will be responsible for the expences in case of illness or accident;

· be responsible for financial losses caused by any breach of the exchange contract that I affect.

I agree with the terms stated above and overleaf.

...........................................................................

DATE SIGNATURE OF THE STUDENT

This Rules Form must be filled in, enclosed and sent together with the Card of Confirmation.

IFMSA SCOPE exchange student´ s responsibilities and regulations of the Clerkship.

• The Exchangee should present the Card of Acceptance or a copy of it to the person in charge upon arrival to the host country.
• The Exchangee is obliged to attend the Clerkship for its whole duration.
• The Exchangee must strictly follow all the instructions given by the department and the Local Committee. Failure to do so may result in cancellation of the remaining clerkship and losing all his/her rights without compensating for any of the extra expenses that exchangee might have.
• Exchangee should arrive the first day of the Clerkship, and never later than 3 days after the commencement of the Clerkship. If failing to do so, and do not informing the Local Committee about it, the Clerkship is no longer guaranteed. The dates are defined on the Card of Acceptance.
• When accepting the clerkship, the Exchangee guarantees by signing the Card of Confirmation to arrive on the date agreed upon with the Local Committee of the hosting organisation. Any change or delay must be reported and agreed upon with the Local Committee of the hosting organisation.
• The Exchangee is responsible for his/her own health/liability insurance. The insurance has to be arranged by the Exchangee before leaving his/her country. The Exchangee is responsible for paying any costs in case of illness or accident.
• The Exchangee shall be responsible for any financial loss caused by any breach of his/her contract that he/she effects.
• The Exchangee has to show the adequate knowledge of English language or the native language of the host country or the language agreed upon in order to carry out the clerkship, otherwise he/she can be refused in the host country and excluded from exchange program.
• The Exchangee must return the Card of Confirmation no later than one month before the beginning of the clerkship. If it is not received, the NMO has the right to cancel his/her clerkship.
• In case the hosting NMO is not fulfilling its obligations towards the Exchangee, the student is obliged to discuss the problems with the Local Committee and the tutor first, and to inform his/her own Local/National Exchange Officer immediately.
• No additional costs can be raised from the Exchangee in the host country unless indicated in the Exchange Conditions.
• The Exchnagee must abide by the SCOPE regulations or the exchangee will be rejected upon arrival or during the course of the Professional Exchange Program.
• There are special exchange conditions for each country (www.ifmsa.net/public). Please consult it with your Local/National Exchange Officer.