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TIPH Ambassador 2022-2023 Welcome Form

Name*
First Last
Preferred Email*
Phone
Preferred Pronouns
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Current Institution*
Degree and Concentration (e.g. MPH - Maternal & Child Health)*
Are you interested in taking over TIPH Social Media for a week during your cohort?*
Please select your interest level related to your experience with Canva** product. Priority for takeovers will be given to those with Canva** experience. (**or equivalent)
- Yes - Solo Takeover (I have Canva** experience)
- Yes - Solo or Collaborative Takeover (I have Canva** experience)
- Yes - Collaborative Takeover (I have limited or no Canva** experience)
- Not Interested in Participating in a Social Media Takeover
Based on your experience and interest please identify which project you would be interested in:*
Please identify here which project you may be interested in completing. If you are interested in doing an in-person/virtual presentation please select that option. If you plan on doing a presentation (in-person or virtual) you are not required to complete an additional project.
- Virtual Public Health Presentation (no additional project required)
- In-Person Public Health Presentation (no additional project required)
- Creating Graphic Designs
- Book Club
- Video Production
- Photography
- Developing Public Health Classroom Activities
- Interviewing Public Health Professionals
- Developing Ambassador Newsletter Content
- Public Health Policy Initiatives
- Assisting with the New Student Network
- Panel Discussion/Webinar
- Creating Student Story Article
- Presenting at a Monthly Ambassador Networking Session
- Providing Additional Social Media Support
- Assisting our internal Diversity, Equity and Inclusion initiatives
- Supporting with our Climate Change Initiatives
What are your initial ideas for a project or presentation?*
It is early in the program, but we want you to start thinking about what project or presentation you would be interested in. This information is only meant for brainstorming and you may change your idea from what you include here. For those interested in more than one project please also include your other interest here.
Are you a domestic or international student?*
- Domestic
- International
Are you affiliated with any national scholarship programs? If so, please share which programs.
Anticipated Graduation Month and Year*
Undergraduate Institution*

Please use full name, not abbreviations (e.g. University of Virginia, not UVA)
Undergraduate Major*
Hometown City, State/Country*
If you are working, what is your current job? (Title/Organization)

(Enter N/A if you're not working while studying)
Why do you love public health?*
* Indicates required field
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Email
This field is for validation purposes and should be left unchanged.

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