Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RHISE Fall 2018 Executive Board Application Form
Join Resolving Health Inequities through Service and Education!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Full Name
*
Your answer
Year (as of Fall 2018)
*
Freshman (1st/2nd semesters)
Sophomore (3rd/4th semesters)
Junior (5th/6th semesters)
Senior (7th/8th semesters)
UConn Email
*
Your answer
Major
*
Your answer
Other Extra Curriculars
*
Your answer
Positions Applying For (up to 3)
*
President
Vice President
Secretary
Treasurer
Community Service Chair
Community Service Chair - Community Project
Fundraising Chair
Education and Awareness Chair
Medical Relations Chair
Required
What are your post-grad plans?
*
Your answer
What is your 'reason' for being interested in healthcare, education, or inequity? What motivates you? Is it personal, general, experience-based?
*
Your answer
What do you think would be a good semester project or focus for UConn RHISE to tackle next semester? Some things we've done in the past are a sustainable garden project with elementary school-aged kids in low-income housing, a meal swipe project to support nutrition inequity, and a social media campaign to protest child marriage across the world!
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report