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Medical Exchange Program

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Pre-Arrival Form

Please only fill out this form if you have been officially accepted to the program.


Last Name * Please enter your legal name as it appears on your passport.
First Name *
Birthdate *
Email *
Nationality * Passport Nationality
Other Nationality Other nationality if not listed.
Gender *

Academic information

Home University *
Major
Minor
Academic Status

Language Proficiency

Level of French
Host University Top Choice
French Consulate * Please indicate the French Consulate through which you will be applying for your visa.
Appointment Date

ID Photo Please attach a Passport size ID Photo.

Stay in France

Teaching Assistantship Only select yes if you have already applied through the MICEFA for one of these positions.

Au-pair Mark if you are interested in an au-pair position, requiring 15 to 20 hours per week of babysitting or tutoring in exchange for free housing.
Length of Stay
Estimated Arrival Date
Date of arrival in France, not date of departure.

Housing Budget
Temporary Housing Do you want to reserve MICEFA Temporary housing? It is reserved on a first-come-first-serve basis and is limited.

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