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MedCoach Bursary Application
13
Questions
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1
Please enter your E-mail
example@example.com
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2
Under which stream are you applying for the MedCoach Bursary?
*
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Visible minority
Low income background
Rural applicant
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3
What is your annual household income?
*
This field is required.
$0-$20,000
$20,000-$30,000
$30,000-$40,000
>$40,000
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4
What is your main method of transportation?
*
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Bus, subway, walk
Taxi/Uber
Owned or leased car
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5
How many children do you have?
*
This field is required.
0
1
2
3+
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6
How often do you travel by plane?
*
This field is required.
Never
0-1 times a year
1-3 times a year
3-6 times a year
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7
How many times a week do you eat at restaurants?
*
This field is required.
0
1
2
3+
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8
Were you born outside of Canada or the US?
*
This field is required.
Yes
No
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9
Have you ever needed to choose between work and volunteering?
*
This field is required.
Yes
No
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10
Have you ever needed to get food from a food bank?
*
This field is required.
Yes
No
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11
Describe why you want to enter the healthcare field
*
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12
If you answered yes to any of the questions above, how do you feel your situation has shaped who you have become? And how will it continue to shape who you will be in the healthcare field?
*
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13
What do you think schools can do to improve access to healthcare programs for students who identify as low-SES?
*
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