CHSP HOME

Program
Eligibility & Application
Resources
News & Events
Contact


Rolando Aldana reads to the CHSP community while Mom, Vivian Chavez, PhD, CHSP Alumna listens at the 2001 MiniNetworking/Selection Meeting in Ann Arbor.
Eligibility & Application: Request Brochure

REQUEST A BROCHURE

If you would like to receive a brochure containing information about the Community Health Scholars Program, please fill out the form below:


Those areas marked with an asterisk * are required to submit this form.

*Name  

*Email  

*Home  
Phone
  

*Business  
Phone
  

*Citizenship  

*Address  

*City  

*State  

*ZIP  

*Country  


*I am willing to relocate to one of the three training sites for the duration of the fellowship and understand that this is a requirement for application.


*Month/Year doctoral degree granted or expected (e.g. 8/02):


*Type of degree expected:


If Other Degree, please explain:


If Other Degree, in what field?


Other questions or comments?


*How did you hear about the Community Health Scholars Program?