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Y4P Leader Application
Thank you for your interest in being a You4Prevent leader! In order to be a leader, you must be a medical student, resident or physician.
Questions? Contact Nikki at
s.n.wyman@emory.edu
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* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
What level of training are you at?
*
E.g. medical student, resident, physician, MPH, etc.
Your answer
Current or former medical school/place of training
*
Your answer
Do you speak a language besides English
*
Yes
No
If yes, what language(s)?
Your answer
Describe your interest in promoting health and wellness
*
Your answer
Describe your interest in working with refugee or underserved communities
*
Your answer
Describe your interest in mentoring pre-medical students.
*
Your answer
What experiences have you had, if any, working in these capacities?
*
Your answer
Anything else?
Your answer
Thank you for your interest!
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