Public Health Advocates Program
Thank you for your interest! We are really excited to read your application. Please email sparekh@stanford.edu if there are any questions/comments/concerns about this application.
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Name *
Please enter your preferred name.
Which high school do you attend? *
If you are in between schools, which high school will you be attending next year?
Which grade will you be entering in the Fall? *
What is your cell phone number? *
If you do not have a cell phone number, what is a number where you can be reached at?
What is your home phone number? *
If you do not have a home phone number, what is a number where you can be reached at?
Who is your emergency contact? *
Please list first and last name
What is this person's relationship to you? *
Choose other if none of the options apply.
What is the phone number for your emergency contact? *
Include area code
What is your email address? *
You must be reachable by this email address. Plan to check this email address at least once per day.
What is your home address?
This information will be kept confidential.
Gender *
Age *
How are you currently?
Ethnicity
What ethnicity do you identify with most strongly?
How interested are you in public health? *
Not Interested
Incredibly Interested
How interested are you in teaching your peers about public health? *
Not Interested
Incredibly Interested
How interested are you in starting a Public Health Advocates Club at your school? *
Responsibilities would include creating an after-school club, teaching the Public Health Advocates curriculum, and organizing volunteer service for members.
Not Interested
Incredibly Interested
What other commitments do you have during the school year, besides the school year. Please list hours per week spent on each commitment. *
Please include all activities you feel are applicable. Format your answer as: Name of Activity - Number of hours per week.
What strategies do you use to manage your time?
We are looking for techniques you use to balance the different activities in your life. We will not consider entries longer than 200 words.
Statement of Interest - Why are you interested in attending this summer session? *
Please limit your responses to 200 words. We will not consider entries longer than 200 words.
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