{"id":3493,"date":"2026-05-18T13:13:25","date_gmt":"2026-05-18T17:13:25","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/ghbusm\/?page_id=3493"},"modified":"2026-05-19T09:49:28","modified_gmt":"2026-05-19T13:49:28","slug":"gh-elective-add-form","status":"publish","type":"page","link":"https:\/\/www.bumc.bu.edu\/ghbusm\/gh-elective-add-form\/","title":{"rendered":"GH Elective Add Form"},"content":{"rendered":"<p>This form is for fourth-year students who would like to add a Global Health (GH) Elective to their fourth year schedule.<\/p>\n<p><strong>Directions for the Student<\/strong><\/p>\n<p>Complete the form below. Once the form is submitted, the elective will be approved by <a href=\"mailto:anagreg@bu.edu\">Ana Gregory<\/a> and\/or Joseph Leanza, MD (GH Program) then added to your schedule by the registrar. Please allow 4-5 business days to see the elective on your schedule. All students must complete the <a href=\"https:\/\/www.bumc.bu.edu\/ghbusm\/acknowledgement-and-waiver-of-liability\/\">waiver of liability form<\/a> for the elective to be approved.<\/p>\n<p>The form below will ask if your elective is an inside or outside elective:<\/p>\n<ul>\n<li>Inside electives (those with established affiliations and automatically approved) are listed here: <a href=\"https:\/\/www.bumc.bu.edu\/ghbusm\/setupelective\/inside-bu-electives\/.\">inside electives<\/a><\/li>\n<li>All other electives are considered <a href=\"https:\/\/www.bumc.bu.edu\/ghbusm\/setupelective\/outside-electives\/\">outside electives<\/a><\/li>\n<\/ul>\n<p><strong>Approval of Electives<\/strong><\/p>\n<p>Any <a href=\"https:\/\/www.bumc.bu.edu\/ghbusm\/setupelective\/inside-bu-electives\/.\">inside elective<\/a> or any elective that is listed in the <a href=\"http:\/\/wwwapp.bumc.bu.edu\/busm\/enrichmentopps\/PostExperienceSearch.aspx\">GH Health Post-Experience Summaries<\/a> (database of elective summaries by BU medical students who have undertaken GH electives in the past) is automatically approved. If you do not find your elective in the directory (i.e., it is new to us), you must meet with Dr. Leanza for approval.<\/p>\n<p><strong>Required Responsibilities for Students Undertaking GH Electives<\/strong><\/p>\n<p>All students who undertake a GH elective must complete the list of <a href=\"https:\/\/www.bumc.bu.edu\/ghbusm\/setupelective\/responsibilities\/\">required responsibilities<\/a>. You will be asked to indicate below that you understand this.<\/p>\n<h2><span style=\"color: #008080;\">GH Elective Add Form<\/span><\/h2>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_17' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_17'  action='\/ghbusm\/wp-json\/wp\/v2\/pages\/3493' data-formid='17' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_17_5\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_5\"><label class='gfield_label gform-field-label' for='input_17_5' >Today&#039;s Date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_5' id='input_17_5' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_17_5_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_17_5_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_17_5' class='gform_hidden' value='https:\/\/www.bumc.bu.edu\/ghbusm\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_17_81\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_81\"><h2 class=\"gsection_title\">Student Information<\/h2><\/li><li id=\"field_17_1\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_1\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Student Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_1'>\n                            \n                            <span id='input_17_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_17_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_17_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_17_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_17_119\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_119\"><label class='gfield_label gform-field-label' for='input_17_119' >Class year of student<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_17_119' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_31\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_31\"><label class='gfield_label gform-field-label' for='input_17_31' >Student E-mail<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_31' id='input_17_31' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_17_99\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_99\"><h2 class=\"gsection_title\">Emergency Contact Info<\/h2><\/li><li id=\"field_17_120\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_120\">This information is collected in the event of an emergency while you are abroad.<\/li><li id=\"field_17_100\"  class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_100\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Name of emergency contact<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_100'>\n                            \n                            <span id='input_17_100_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_100.3' id='input_17_100_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_100_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_17_100_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_100.6' id='input_17_100_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_17_100_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_17_101\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_101\"><label class='gfield_label gform-field-label'  >What is your relationship to the emergency contact person listed above?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_101'>\n\t\t\t<li class='gchoice gchoice_17_101_0'>\n\t\t\t\t<input name='input_101' type='radio' value='Mother'  id='choice_17_101_0'    \/>\n\t\t\t\t<label for='choice_17_101_0' id='label_17_101_0' class='gform-field-label gform-field-label--type-inline'>Mother<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_101_1'>\n\t\t\t\t<input name='input_101' type='radio' value='Father'  id='choice_17_101_1'    \/>\n\t\t\t\t<label for='choice_17_101_1' id='label_17_101_1' class='gform-field-label gform-field-label--type-inline'>Father<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_101_2'>\n\t\t\t\t<input name='input_101' type='radio' value='Partner'  id='choice_17_101_2'    \/>\n\t\t\t\t<label for='choice_17_101_2' id='label_17_101_2' class='gform-field-label gform-field-label--type-inline'>Partner<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_101_3'>\n\t\t\t\t<input name='input_101' type='radio' value='gf_other_choice'  id='choice_17_101_3'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_17_101_other' name='input_101_other' type='text' value='Other' aria-label='Other' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Other\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Other\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_102\"  class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_102\"><label class='gfield_label gform-field-label' for='input_17_102' >Cell phone for emergency contact person<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_102' id='input_17_102' type='text' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_17_103\"  class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_103\"><label class='gfield_label gform-field-label' for='input_17_103' >Email for emergency contact person<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_103' id='input_17_103' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_17_104\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_104\"><h2 class=\"gsection_title\">Course to Add to Your Schedule<\/h2><\/li><li id=\"field_17_32\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_32\"><label class='gfield_label gform-field-label' for='input_17_32' >Course name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_17_32' type='text' value='' class='medium'  aria-describedby=\"gfield_description_17_32\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_17_32'>E.g., Infectious Disease in India, Medical Spanish in Guatemala<\/div><\/li><li id=\"field_17_109\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_109\"><label class='gfield_label gform-field-label'  >Is this an inside or outside elective?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_109'>\n\t\t\t<li class='gchoice gchoice_17_109_0'>\n\t\t\t\t<input name='input_109' type='radio' value='Inside elective'  id='choice_17_109_0'    \/>\n\t\t\t\t<label for='choice_17_109_0' id='label_17_109_0' class='gform-field-label gform-field-label--type-inline'>Inside elective<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_109_1'>\n\t\t\t\t<input name='input_109' type='radio' value='Outside elective'  id='choice_17_109_1'    \/>\n\t\t\t\t<label for='choice_17_109_1' id='label_17_109_1' class='gform-field-label gform-field-label--type-inline'>Outside elective<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_17_109'>See info above on inside and outside electives.<\/div><\/li><li id=\"field_17_108\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_108\"><label class='gfield_label gform-field-label' for='input_17_108' >Block of the elective<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_108' id='input_17_108' type='text' value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_112\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_112\"><label class='gfield_label gform-field-label' for='input_17_112' >Start date of your elective<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_112' id='input_17_112' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_17_112_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_17_112_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_17_112' class='gform_hidden' value='https:\/\/www.bumc.bu.edu\/ghbusm\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_17_113\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_113\"><label class='gfield_label gform-field-label' for='input_17_113' >End date of your elective<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_113' id='input_17_113' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_17_113_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_17_113_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_17_113' class='gform_hidden' value='https:\/\/www.bumc.bu.edu\/ghbusm\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_17_114\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_114\"><h2 class=\"gsection_title\">Evaluator Information<\/h2><\/li><li id=\"field_17_118\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_118\">Please provide information for the person who will evaluate you. An evaluation will be sent directly to this person.<\/li><li id=\"field_17_35\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_35\"><label class='gfield_label gform-field-label' for='input_17_35' >Evaluator name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_17_35' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_123\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_123\"><label class='gfield_label gform-field-label' for='input_17_123' >Organization of evaluator<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_123' id='input_17_123' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_124\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_124\"><label class='gfield_label gform-field-label' for='input_17_124' >Evaluator title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_124' id='input_17_124' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_115\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_115\"><label class='gfield_label gform-field-label' for='input_17_115' >Organization address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_115' id='input_17_115' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_125\"  class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_125\"><label class='gfield_label gform-field-label' for='input_17_125' >Evaluator phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_125' id='input_17_125' type='text' value='' class='small'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_17_117\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_117\"><label class='gfield_label gform-field-label' for='input_17_117' >Evaluator email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_17_117' type='text' value='' class='medium'  aria-describedby=\"gfield_description_17_117\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_17_117'>This must be an organizational or institutional email address (not Gmail, e.g.).<\/div><\/li><li id=\"field_17_122\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_122\"><label class='gfield_label gform-field-label' for='input_17_122' >Country where this elective will take place<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_122' id='input_17_122' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_17_90\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_90\"><h2 class=\"gsection_title\">Understanding Your Responsibilities<\/h2><\/li><li id=\"field_17_121\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_121\"><label class='gfield_label gform-field-label'  >Did you complete the waiver of liability form (must be submitted for the elective to be approved - see link above).<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_121'>\n\t\t\t<li class='gchoice gchoice_17_121_0'>\n\t\t\t\t<input name='input_121' type='radio' value='Yes'  id='choice_17_121_0'    \/>\n\t\t\t\t<label for='choice_17_121_0' id='label_17_121_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_121_1'>\n\t\t\t\t<input name='input_121' type='radio' value='No'  id='choice_17_121_1'    \/>\n\t\t\t\t<label for='choice_17_121_1' id='label_17_121_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_77\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_77\">\n<\/li><li id=\"field_17_92\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_92\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >All students who undertake a GH elective must complete the required list of responsibilities (see link above). Check the box  below to indicate you understand your responsibilities for a global health elective.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_17_92'><li class='gchoice gchoice_17_92_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.1' type='checkbox'  value='I understand'  id='choice_17_92_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_17_92_1' id='label_17_92_1' class='gform-field-label gform-field-label--type-inline'>I understand<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_126\"  class=\"gfield gfield--type-section gsection bu_google_recaptcha_section field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_126\"><h2 class=\"gsection_title\"><\/h2><\/li><li id=\"field_17_127\"  class=\"gfield gfield--type-html bu_google_recaptcha gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_17_127\"><div class=\"g-recaptcha\" data-sitekey=\"6LeGxkEjAAAAAK4nzHZn3a_6jB2ELSN935WrVBfC\"><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_17' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_17\"]){return false;}  window[\"gf_submitting_17\"]=true;  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_17\"]){return false;} window[\"gf_submitting_17\"]=true;  jQuery(\"#gform_17\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_17' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='17' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_17' value='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' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_17' id='gform_target_page_number_17' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_17' id='gform_source_page_number_17' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\ngform.initializeOnLoaded( function() {gformInitSpinner( 17, 'https:\/\/www.bumc.bu.edu\/ghbusm\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_17').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_17');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_17').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_17').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_17').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_17').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_17').val();gformInitSpinner( 17, 'https:\/\/www.bumc.bu.edu\/ghbusm\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [17, current_page]);window['gf_submitting_17'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_17').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [17]);window['gf_submitting_17'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_17').text());}, 50);}else{jQuery('#gform_17').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [17, current_page]);gform.utils.trigger({ event: 'gform\/postRender', native: false, data: { formId: 17, currentPage: current_page } });} );} );\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"<p>This form is for fourth-year students who would like to add a Global Health (GH) Elective to their fourth year schedule. Directions for the Student Complete the form below. Once the form is submitted, the elective will be approved by Ana Gregory and\/or Joseph Leanza, MD (GH Program) then added to your schedule by the [&hellip;]<\/p>\n","protected":false},"author":11911,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/pages\/3493"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/users\/11911"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/comments?post=3493"}],"version-history":[{"count":19,"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/pages\/3493\/revisions"}],"predecessor-version":[{"id":3520,"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/pages\/3493\/revisions\/3520"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/ghbusm\/wp-json\/wp\/v2\/media?parent=3493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}