TIPH Ambassador 2022-2023 Welcome Form Name* First Last Preferred Email* PhonePreferred Pronouns Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Current Institution*-- Select One --A.T. Still University College of Graduate Health StudiesAmerican University of Beirut - Faculty of Health Sciences, Graduate Public Health ProgramArcadia University College of Health Sciences MPH ProgramBaylor University Public Health ProgramBoston University School of Public HealthBrown University School of Public HealthCampbell University Master of Science in Public Health ProgramCase Western Reserve University MPH ProgramChamberlain University MPH ProgramCharles R. Drew University of Medicine and Science MPH Program in Urban Public HealthClaremont Graduate University Master of Public Health ProgramColorado School of Public HealthColumbia University Mailman School of Public HealthConsortium of Eastern Ohio Master of Public Health ProgramCornell University MPH ProgramCreighton University MPH ProgramCUNY Graduate School of Public Health and Health PolicyDartmouth - Geisel School of Medicine MPH ProgramDePaul University Master of Public Health ProgramDes Moines University Department of Public HealthDrexel University Dornsife School of Public HealthEast Carolina University MPH ProgramEast Tennessee State University College of Public HealthEmory University Rollins School of Public HealthFlorida A&M University Public Health ProgramFlorida International University Robert Stempel College of Public Health and Social WorkGeorge Mason University Graduate Programs in Public HealthGeorge Washington University Milken Institute School of Public HealthGeorgia Southern University Jiann-Ping Hsu College of Public HealthGeorgia State University School of Public HealthHarvard T.H. Chan School of Public HealthHofstra University MPH ProgramIcahn School of Medicine at Mount Sinai, Graduate Program in Public HealthIndiana University Richard M. Fairbanks School of Public Health - IndianapolisIndiana University School of Public Health - BloomingtonJohns Hopkins Bloomberg School of Public HealthKent State University College of Public HealthLoma Linda University School of Public HealthLong Island University, Brooklyn Master of Public Health ProgramLouisiana State University Health Sciences Center School of Public HealthLoyola University Chicago Parkinson School of Health Sciences and Public HealthMeharry Medical College Division of Public Health PracticeMercer University Department of Public HealthMichigan State University MPH ProgramNational Institute of Public Health of Mexico (Instituto Nacional de Salúd Publica)National Taiwan University College of Public HealthNew England Institute of Technology MPH ProgramNew York Medical College, School of Health Sciences and Practice, and Institute of Public HealthNew York University School of Global Public HealthNorth Dakota State University Department of Public HealthNortheastern University MPH ProgramNorthwestern University Feinberg School of Medicine Program in Public HealthOhio State University College of Public HealthOregon Health & Science University/Portland State University School of Public HealthOregon State University College of Public Health and Human SciencesPennsylvania State University Public Health ProgramPurdue University Department of Public HealthRutgers School of Public HealthSacred Heart University Master of Public Health ProgramSaint Louis University College for Public Health and Social JusticeSan Diego State University School of Public HealthSouthern Connecticut State University Public Health ProgramSt. Ambrose University, Master of Public Health ProgramSt. Catherine University Public Health ProgramSt. George's University Department of Public Health and Preventive MedicineStony Brook University Program in Public HealthSUNY Downstate School of Public HealthTemple University College of Public HealthTexas A&M School of Public HealthTexas Tech University Health Sciences Center School of Population and Public HealthThe University of Texas Health Science Center at Houston School of Public HealthThomas Jefferson University, College of Population Health - MPH ProgramTouro University - California MPH ProgramTufts University School of Medicine, Public Health ProgramTulane University School of Public Health and Tropical MedicineUCLA Jonathan and Karin Fielding School of Public HealthUniformed Services University of the Health Sciences Public Health ProgramUniversity at Albany School of Public HealthUniversity at Buffalo School of Public Health and Health ProfessionsUniversity of Alabama at Birmingham School of Public HealthUniversity of Arizona Mel and Enid Zuckerman College of Public HealthUniversity of Arkansas for Medical Sciences Fay W. Boozman College of Public HealthUniversity of California, Berkeley School of Public HealthUniversity of California, Davis MPH ProgramUniversity of California, Irvine - Public Health, Epidemiology, Environmental Health SciencesUniversity of Cincinnati College of Medicine MPH ProgramUniversity of Delaware MPH ProgramUniversity of Florida College of Public Health and Health ProfessionsUniversity of Georgia College of Public HealthUniversity of Hawai?i at M?noa Public Health ProgramUniversity of Hong Kong MPH ProgramUniversity of Illinois at Chicago School of Public HealthUniversity of Illinois at Urbana-Champaign College of Applied Health SciencesUniversity of Iowa College of Public HealthUniversity of Kansas School of Medicine KU - MPH ProgramUniversity of Kentucky College of Public HealthUniversity of Louisville School of Public Health and Information SciencesUniversity of Maryland School of Medicine Public Health ProgramsUniversity of Maryland School of Public HealthUniversity of Massachusetts Amherst School of Public Health and Health SciencesUniversity of Memphis School of Public HealthUniversity of Miami Department of Public Health SciencesUniversity of Michigan School of Public HealthUniversity of Michigan-Flint Master of Public HealthUniversity of Minnesota School of Public HealthUniversity of Nebraska Medical Center College of Public HealthUniversity of Nevada, Las Vegas School of Public HealthUniversity of Nevada, Reno School of Public HealthUniversity of New England Graduate Program in Public HealthUniversity of New Haven Public Health ProgramUniversity of New Mexico College of Population Health Master of Public HealthUniversity of North Carolina at Charlotte Public Health ProgramsUniversity of North Carolina Gillings School of Global Public HealthUniversity of North Dakota Master of Public Health ProgramUniversity of North Texas Health Science Center School of Public HealthUniversity of Oklahoma Health Sciences Center Hudson College of Public HealthUniversity of Pennsylvania Master of Public Health ProgramUniversity of Pittsburgh School of Public HealthUniversity of Puerto Rico Graduate School of Public HealthUniversity of Rochester Graduate Public Health ProgramsUniversity of South Carolina Arnold School of Public HealthUniversity of South Florida College of Public HealthUniversity of Southern California Programs in Public HealthUniversity of Texas Medical Branch School of Public and Population HealthUniversity of Toledo Master of Public Health ProgramUniversity of Utah Public Health ProgramUniversity of Vermont Larner College of Medicine MPH ProgramUniversity of Virginia MPH ProgramUniversity of Washington School of Public HealthUniversity of Wisconsin-Milwaukee Joseph J. Zilber School of Public HealthUpstate Medical University Public Health ProgramVanderbilt University Institute for Medicine and Public HealthVirginia Commonwealth University Graduate Public Health ProgramsVirginia Tech Public Health ProgramWalden University College of Health Sciences and Public PolicyWashington University in St. Louis - Brown School Public Health ProgramsWest Virginia University School of Public HealthWright State University MPH ProgramYale School of Public HealthDegree 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 CAPTCHAEmailThis field is for validation purposes and should be left unchanged.