First Name *

Last Name *

Phone *

Email *

Date of birth *

Will you be 18 years or older at the time of travel? Not applicable for High School Remote Research Program. *

Country of Residence

Which school or university do you attend? *

What level of education are you currently enrolled in? *

University Program

What is your current GPA or GPA at graduation if you have already graduated? *

Please provide your LinkedIn profile link.

Which program are you are applying for? (Choose only ONE) *

Which cohort you are interested in joining? (Choose only ONE) *

Which country you are interested in traveling to? (Choose only ONE) *

Which dates are you interested in traveling? (Study Abroad Only)

Which dates are you interested in for remote research program? (Remote Only)

Do you have a current passport or the ability to obtain one within 3 months?

Are you seeing university credit or using this internship to fill a university requirement such as a practicum or capstone project? *

If yes, how many internship hours are required?

Why are you interested in this internship opportunity?

Please provide a 250-500 word written or video essay explaining what qualities and experience you will bring to your team. Remember this is an educational experience, we are not as concerned with your skills as we are about how you will work within your team and what soft skills you are committed to utilizing in this program. To provide a video essay, please upload it to a cloud location (ie Google drive, icloud), paste the direct access link in a document, then upload the document here. *

Please upload a copy of your resume. *

I agree to undergo a background check in accordance with federal regulation. *

Agree

If yes, please provide details.

Have you ever been convicted of a crime? *

Please provide the name, affiliation, and email address for two personal or professional references not related to you. Reference 1 *

Reference 2 *

How did you hear about us? *

If you were referred by a student intern or GHL employee, please provide their name here.

I understand that this is an educational opportunity and there is a program fee for participation in all Global Health Leaders Programs. Program fee information is available at www.globalhealthleaders.net. *

I understand

Signature *

Clear

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.