Ambassador Welcome Form

This is Public Health (TIPH) Ambassador Program

Welcome to the TIPH Ambassador Program!
We’re thrilled to have you join the 2024-25 cohort of TIPH Ambassadors. To get started, please complete the welcome form by July 23rd. This will help us enter all your information into our onboarding system, ensuring a smooth start for everyone.

Some questions may seem repetitive if you’ve filled out the supplemental form, but we need all the most updated information in one place. We appreciate your understanding and cooperation.

Cohort Term: August 2024 – June 2025

Thank you, and we look forward to an amazing year together!

TIPH Ambassador Program 2024-2025 Welcome Form

Name*
First Last
Preferred Email*
Pronouns
Phone
Current Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Current Institution*
Degree and Concentration (e.g. MPH – Maternal & Child Health)*
Interest/Topic Area*
Please specify your primary areas of interest or topics you are passionate about (e.g., elder care, tropical medicine, water safety, food insecurity, veteran’s health, nutrition). This helps us tailor our programs, communications, and networking opportunities to better suit your preferences and needs, and connect you with other TIPH Ambassadors interested in similar topics.
Are you interested in taking over TIPH Social Media for a week or weekend during your cohort?*
Please provide your preference for the social media takeover. We are asking this question again in case your response has changed since completing the supplemental form. While we cannot guarantee a specific takeover week, your input helps us plan and accommodate as many preferences as possible.
- Yes – Solo Takeover
- Yes – Collaborative Takeover (with another Ambassador)
- Not Interested in Participating in a Social Media Takeover
Are you a domestic or international student?*
- Domestic
- International
Will you be at the APHA Conference?
The American Public Health Association (APHA) Annual Meeting and Expo will be held October 27-30 in Minneapolis, MN.
- Yes
- No
- Not Sure
Anticipated Graduation Month and Year*
Example: May 2025
Undergraduate Institution*
Please use full name, not abbreviations (e.g. University of Virginia, not UVA)
Undergraduate Major*
Current Job Title
If you are currently working in the field of public health please include your job title here.
Current Employer
If you’re currently working in public health, please share the name of your employer here.
* Indicates required field
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Phone
This field is for validation purposes and should be left unchanged.