Applicant information

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* 1. Last name

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* 2. First name

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* 3. Email address

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* 4. Student number

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* 5. Academic program:

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* 6. Program details (e.g., MSc in Epidemiology)

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* 7. Year of study / graduation year (e.g., Y1 / 2026)

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* 8. Are you registered in the Concentration in Global Health and Social Accountability?

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* 9. Please describe your interest in climate change, global health and planetary health and how participating in this workshop will enrich your education and experience (max. 200 words).

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* 10. Please explain if you currently involved or would you like to be involved in any sustainability or climate action initiatives in your local community or at the Faculty of Medicine (max. 200 words)

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* 11. Please upload a copy of your CV (max. 3 pages).

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 12. It is important to note that this workshop can be offered to a restricted number of participants to allow proper discussions and facilitations. The IGHO team is covering the fees for all participants. Thereby, it is important to read through the conditions below and confirm that by submitting this form, you are agreeing to all the following statement (please tick all statements):

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