Medicine Interviewer Application

If you are unsure if you have previously registered with us then please email us at med-admissions@contacts.bham.ac.uk and we can check our records before you fill in this form.

Nomination and Application to become a University of Birmingham Medical School Interviewer
Name *

First name

Last name
Email*
Job Title*
Workplace Address *

Address Line 1

Address Line 2

City

County

Postcode

Country
Contact phone number (for emergency contact on the day)*
I confirm that I will not disclose information about interviewer training or interview content for Medical school interviews to third parties.*
Confirmed
I confirm that I will not disclose the content of interviewer training or interview questions to third parties*
Confirmed
Recommendation
Who recommended that you become an interviewer for the Birmingham Medical School?
Name *

First name

Last name
Job title and role*
Email*