Travel Grant Application for Medical Students

  • Fourth-year medical students may use the following application to apply for a travel grant for a GH elective. Due to the Covid epidemic, applicants must complete and submit the following document as part of the application: Covid Action Plan. Applications are processed on a rolling basis with a funding determination sent to the student within 3 weeks of submission. If you do not receive a response within 3 weeks of submission, email Ana Gregory.
  • Date Format: MM slash DD slash YYYY
  • Section I: Student Information

  • Please enter a number from 2020 to 2030.
  • Section II: Host Information

  • Section III: Details of Your Elective

    NOTE: The quality of the information that you provide below will assist the funding committee in determining the amount of funding you will receive. Provide as many details as possible in a well-written manner.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • NOTE: BUSM GH Program will not give academic credit for, pay for, supervise, direct, or otherwise support a medical student in a country where a U.S. State Department Travel Warning is in effect. See Travel Warning Policy.
  • 19. Estimated Trip Costs:

    DIRECTONS: Enter an estimated dollar amount for each trip expense listed below; the form will total the expenses for you.
  • $0.00
  • Section IV: Personal Reflection/How This Elective Fits into Your Career Plans

  • 29. List the three main educational benefits that you expect to receive from your experience, including curriculum goals and/or post-graduate career plans.
  • Section V: Covid Action Plan

    Submit the Covid Action Plan document. Due to the Covid epidemic, applicants must complete and submit the following document as part of the application: Covid Action Plan.
  • 31. Understand Your Responsibilities and Verify Your Submission

    All students who undertake a 4th-year GH elective must complete the required list of responsibilities. Please review these responsibilities, then check the boxes below to submit your application.