*Deferral of Internship – Category one candidates only*

Deferral is for up to 12 months. Any further period of deferral requires repeat notification to the PMCV and discussion with the PMCV Medical Director. Any person considering deferral of internship should read the PMCV Policy – Deferral of Internship.

Candidates MUST submit this form to PMCV by 5pm AEST, Wednesday 3 July 2024

Section A – Candidate Details

Address(Required)

Section B – Notification of Deferral

This is my first / second deferral of internship (please select)(Required)

Section C – Reason for Deferral

Section D – Declaration

Please indicate that you have read and agree to comply with the Policy:(Required)
MM slash DD slash YYYY