Global Health Doctoral Scholars Program Application: Step One
1.

Please provide contact information

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:
Country:

2.

Duke doctoral program in which you're currently enrolled
 

50 characters left.
3.

Current year in doctoral program
First
Second
Third
Fourth
Fifth
Other  
4.

Which of the following applies to you:
 Yes No Not Applicable   
Currently enrolled in full-time coursework   
Passed qualifying exam   
Preparing dissertation proposal   
Conducting dissertation   
  • Comment:

  • 500 characters left.
5.


Please provide the name of your DGHI faculty mentor
 

50 characters left.
6.

Provide a brief description of your research topic and/or interests.
 

350 characters left.