Public Health Ambassador Application Form - Winter 2023 
As a public health ambassador, you’ll have the opportunity to improve the wellbeing of asylum seekers and refugees in Montreal as a leader, an advocate, a learner and a researcher. The ambassadorship program provides a unique opportunity to improve your clinical and research skills while directly impacting the lives of the families we work with.

Following your submission of this form, you will be notified about the status of your application in the following week. Should your application be accepted, you will be contacted by a member of our team in order to proceed with next steps (signing a confidentiality form, scheduling a virtual training session and discussing your program research engagement).

Hoping to welcome you to our team very soon! 


Please note: This program is only open to McGill MDCM students at this time. Med-P students or those from other programs who are not registered with the CMQ are not eligible. 


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Full name *
McGill Email *
McGill Student ID Number *
Program Year *
What languages do you speak fluently? (Please list all that apply) *
Required
Please briefly outline your prior research experience and/or applicable skills (Example: published manuscript, statistical analysis skills, data management and collection experience). Point form is acceptable. 


Note: We will still accept students without prior experience, this is in order to help us match your skill level to your role in the project(s). 
 *
Why are you interested in becoming a public health ambassador? (max 200 words) *
Thank you for you interest!
If you have any questions, you can email us at: cime.project.montreal@gmail.com

Otherwise, we'll be in touch shortly! 
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