Application for Global Health Elective Credit » Global Health Education Program » College of Medicine

Use this form if you are applying for any Global Health Elective for fourth year credit. Student credit must be verified and approved by Office of International Medical Education and Office of Student Affairs.

Name
First Last
Email
Class of
Leadership in Global Health
Which trip did you travel with (if you travelled on different trips please list each one)?
Which academic year(s) did you travel? Please list years to correspond with trips listed above.
For Local/Global Health Equity Track seminar series credit
criteria- must complete 75% attendance from start date for seminar series credit
When did you start track? (example: January 2018)
For distinction in Local/Global Health Equity
Did you complete a MSRP/LGHET project or a 4th year special project in Global Health?
If so, please list name of mentor and title of project:
CAPTCHA

Leadership in Global Health

For Local/Global Health Equity Track seminar series credit

For distinction in Local/Global Health Equity