Penn Global Health Scholars Application

Name Name Title First Middle Last Suffix
Professional Title
Professional Degree(s)

Examples include: MD, MBBS, PhD, MPH
Are you in a training program

Are you in a training program Yes No
Please list trainee type and year

Example:Resident PGY3, 2022
School/Department
Mailing Address Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone
Email
Personal URL or links to social media presence
Please provide a brief biographical statement (100 words or less) about the nature of your interest in global health and how global health interfaces with your current roles and activities. As this will be used as the bio on your CGH profile, please include your affiliation, title, and any other background information.
Maximum of 100 words allowed. Currently Entered: 0 words.
Please list your global health interest areas
If you work outside the US, please list countries and regions within countries where you work
Please list languages you speak and levels of proficiency
Please provide a brief description of two recent global health related projects you’ve worked on
Please provide a citation (including URL) to your recent publications relevant to global health in which you were an author
Please list all international institutions with which you are affiliated
Do you plan to participate regularly in faculty meetings, seminar series, retreats and/or other Center events?

Do you plan to participate regularly in faculty meetings, seminar series, retreats and/or other Center events? Yes No
Do you regularly teach Global Health courses at Penn? If so, which ones?
Briefly describe how you plan to collaborate significantly with other Center Faculty in research and scholarship.
Briefly describe how you will provide advice and mentorship to trainees studying global health (e.g., MD students, MPH, residents, fellows, etc.)
Briefly describe your availability for individual lectures in global health courses, service on committees, teach global health coursework.
Please list any global health topics you would like to explore through CGH sponsored events, lectures, or training.
How did you hear about this opportunity?