Personal Information and Site Preference Form
Please complete all questions that apply.
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メールアドレス *
Last Name *
First Name *
JHED *
SIS ID or Hopkins ID *
What is your citizenship? *
School *
Department *
Degree Program (MSPH, PhD, etc) *
Area of Concentration *
Expected Graduation Date *
YYYY
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MM
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JH/Departmental Academic Advisor *
Who will be submitting your Letter of Recommendation for this application? *
Are you currently on payroll at Johns Hopkins? *
Commitments: *
No
Yes
If selected (and applicant accepts) for this placement I will complete the full term of the placement except in extenuating circumstances.
The duration of the placement will be no shorter than 8 weeks and l will work with the faculty member and local staff to coordinate the timing of the placement that best accommodates the project. I agree to spend at least 4 weeks on site in the low-to middle-income country if travel is available.
I affirm that I will be returning to school to complete their degree. The applicant cannot matriculate before or during the placement.
If selected for this placement I will enroll in and pass the course 220.600.81 “International Travel Preparation, Safety, & Wellness” during either 3rd or 4th Term of 2020 at JHSPH. This must be completed before I depart for their placement.
If selected for this placement I will present on my experience at Global Health Day during the academic year following the completion of the project.
If selected for this placement I will submit a personal reflection statement and 5 hi-res photos no later than 1 month after returning to Hopkins, and agrees to allow CGH the rights to publish said photographs along with appropriate photo credit attribution
If selected for this placement, I will complete all appropriate vaccinations and other health requirements before departure to the field.
I agree to conduct myself with the highest integrity and uphold the reputation of Johns Hopkins University.
Applicant Signature (Please type first and last name) *
Date Signed *
YYYY
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MM
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Site Preferences and Rankings
Number of sites applying to: (**GHEFP applicants are expected to apply to three sites in order to increase their odds of achieving a match. If you opt to apply to one or two sites you must notify the Student Program Coordinator of your decision via email JHSPH.ghgrants@jhu.edu) *
Site Preferences
Please list up to three placement sites for which you wish to be considered.  You should copy the names from the CGH website list and must include the ID number.
1st Choice: Project ID# *
1st Choice: Site/Project Title: *
1st Choice: Faculty Mentor *
2nd Choice: Project ID#
2nd Choice: Site/Project Title:
2nd Choice: Faculty Mentor
3rd Choice: Project ID#
3rd Choice: Site/Project Title:
3rd Choice: Faculty Mentor
Thank you!
Thank you for your submission to the GHEFP 2021 program.

Faculty members have been given one month to review applications, conduct interviews, and return their choices in preference order. Please note that not all faculty choose to conduct interviews - if you are not contacted for an interview it does not necessarily mean you will not be matched.

During this review month students have one opportunity to change their site preference order. You must schedule a Zoom call with the Student Program Coordinator to submit an official site preference change request. Email requests will not be accepted. Please click here to schedule your conversation: https://calendly.com/meagan-/ghefp-site-preference-change

 Site changes must be done by March 16, 2020 at 5:00pm EST.

The CGH takes the matching process very seriously. This program is designed for faculty and students to create new collaborations and think through best possible fits by taking into consideration faculty and student preferences. Faculty and students should not discuss rankings with one another in order to create a match. Last year over half of our awardees were not 1:1 matches and we are proud of being able to fund many variations of a match to place as many students as possible.

We anticipate being able to announce matches on or around March 19, 2021. Students who choose to accept the award will be required to complete our orientation and attend a mandatory meeting on April 7, 2021 along with other pre-departure and financial disbursement requirements.

Please don't hesitate to contact us if you have any questions or concerns. Best of luck!

The CGH Team

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