Student Leader Application

If you are interested in becoming a Student Leader and founding a new MEDLIFE student chapter at your school please fill out this application!

Are you interested in global health?  Social justice?  Developmental aid?  MEDLIFE is a network of students across North America that are committed to helping poor families lift themselves out of poverty. We believe that all people deserve access to MEDs — Medicine, Education and Development — and to that end we commit our resources, time, efforts and hope to bring MEDs to poor families everywhere.
   

Name of College or University: *

Your name: *

Email : *

Email address must be a university associated email to start a new chapter.

Contact Number: *

Major(s): *

GPA: *

Expected Graduation Year: *

Why are you interested in starting a MEDLIFE chapter at your school? What would you like to accomplish through your work with MEDLIFE?: *

Do you have any previous leadership experience? Please elaborate: *

Do you have any previous experience working in global health? Please elaborate: *

How many hours a week will you commit to getting your new MEDLIFE chapter off the ground? : *

Who were you referred by? (optional):

Example: John Smith at Dartmouth suggested I start a chapter at my school.

Is there anything else you would like to tell us about yourself? (optional):

Please upload your most current resumé (optional):

.pdf format preferred

What code is in the image?: *

Enter the characters (without spaces) shown in the image.