Forms

Pre-Application Forms

Declaration of Intent Form (if you intend to complete the Global Health Certificate, please submit this form by Week 10 of the Spring quarter of your first year of graduate study at UCLA)

Prospective Internship Intent Form (once you identify your fieldwork opportunity, please submit this form so CGIH can confirm for you that it will meet the requirements of the certificate)

Global Health Certificate Workplan Template (this is a tool for you to use to plan how you will meet the requirements of the certificate...you do not need to submit this to CGIH)

Global Health Certificate Course Exception Request (if you wish to substitute another UCLA course for one of your required global health electives, please complete and submit this form prior to the quarter you plan to be enrolled in the course)

Forms Needed for Certificate Application

Global Health Certificate Application Form (please submit with final application)

Global Health Certificate Lecture Form (please submit 2 of these with final application)

Additional Reference Materials

Global Health Professional Reflection Essay Requirements (please read this prior to writing your Professional Reflection Essay)

Link to ASPPH Global Health Competencies (please read through these competencies prior to writing your Professional Reflection Essay)