Proyeksi keinginan untuk mengikuti Pendidikan Spesialis/Subspesialis di Program Pascasarjana UGM (Apabila dirasa perlu dapat ditambah pada kertas lain) :
1. Alasan mengikuti Pendidikan Spesialis/Subspesialis di Program Pascasarjana UGM dengan pilihan
program studi tersebut: ....................................................................................................................................................... ....................................................................................................................................................... ....................................................................................................................................................... ....................................................................................................................................................... ....................................................................................................................................................... ..................................................................................................................................... .................. .......................................................................................................................................................
2. Harapan yang diinginkan dari mengikuti Pendidikan Spesialis/Subspesialis di Program Pascasarjana