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Y4P Fellow Application
Thank you for your interest in being a You4Prevent fellow!
Questions? Contact Amritha at amritha.gourisankar@emory.edu
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Email
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Your email
Name
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Your answer
Email
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Your answer
Phone number
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Your answer
What level of training are you at (high school, undergraduate, post-graduate (working), MPH)?
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Include year, and which university, if student
Or place of employment if working
Your answer
Do you speak a language besides English?
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Yes
No
If yes to above, please specify
Your answer
Were you ever part of the Young Physicians Initiative (YPI)?*
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Yes
No
Do you have any experience with teaching, counseling, and motivational interviewing? If so, please describe.
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Your answer
What got you excited when you heard about You4Prevent? What are you passionate about, and how can we help you nurture that?
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Your answer
How did you hear about You4Prevent?
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Your answer
Anything else?
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