2022 Virtual Innovation Exchange

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Thank you for your interest in Engineering World Health's Virtual Innovation Exchange in partnership with the University of New South Wales and Makerere Univeristy. This is a virtual design program with team-based, bioengineering learning goals based on curriculum developed by EWH. Please complete the below form to indicate interest.

First and Last Name *

Email *

zID (if attending UNSW)

Which program are you applying to?

Cambodia (GMT +7)

Uganda (GMT +3)

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Mobile Phone Number

Do you agree to be added to a WhatsApp or GroupMe group?

Yes

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University

University of New South Wales

Makerere University

Other:

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Faculty (if attending UNSW)

Degree or Area of Study

Current Year of Study

Age *

Which country do you reside in? *

Australia

Uganda

Cambodia

Other:

What is your first language? *

Do you speak any other languages? If so, please list below and your level of fluency.

Do you have access to the following items? Please select all that apply. Your response will not affect your application.

Smart phone with regular, consistent internet access

Laptop or desktop computer with regular, consistent internet access

Computer and/or smartphone, but irregular home internet access

Computer and/or smartphone, but no home internet access

Other:

How did you hear about the program? *

Have you participated in an international exchange program (virtual or in-person) before? If yes, please elaborate.

What interests you about this program? Why do you want to participate? *

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