Global Health Leaders Application
First Name
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Last Name
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Email
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example@example.com
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Please enter a valid phone number.
Country of Residence
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United States
Canada
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Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Are you 18 years or older?
*
Please Select
Yes
No
Students must be 18 or older at time of travel for study abroad programs
Program Applying For
*
Please Select
Medical Internship Abroad
Research Internship Abroad
Research Internship Remote - College
Research Internship Remote - High School
Country of Interest
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Dominican Republic
Belize
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Current University/High School
Diploma or Degree Program
Current GPA
Why are you interested in this internship?
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Are you seeking college credit for this internship?
*
Please Select
Yes
No
Global Health Leaders internships include program fees for supervision, room and board, and supplies. If you do not agree, please stop here.
I agree
Are you interested in being a Team Leader with the opportunity to have your program fee reimbursed?
Yes
No
Are you interested in starting a Global Health Leaders Club or Chapter at your High School or University?
Yes
No
Is there anything else you would like us to know about you?
LinkedIn Profile Link
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Resume
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How did you hear about Global Health Leaders?
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LinkedIn Job Posting
Instagram
Facebook
Google
Go Abroad
GHL Intern
GHL Ambassador
GHL University Chapter or Club
Other
University Club or Chapter
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University of Maryland
Midwestern University
Arizona State University
Florida International University
Other
Name of GHL Ambassador who referred you
Please Select
Dr. Arianne Powell
Dr. Cristal Pride
Laura Laurie
Dr. Esmeralda Nunez
Ambar Nunez
Koral Nunez
Vishwaas Nayak
Amol Koli
Kylee Tucholski
Melanie Rodriguez
Dr. Angie Pinales
Name of GHL Student Intern who referred you
May we contact you about future opportunities?
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Yes
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