{"id":557,"date":"2018-09-21T12:38:46","date_gmt":"2018-09-21T16:38:46","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/isep\/?page_id=557"},"modified":"2018-09-21T12:51:38","modified_gmt":"2018-09-21T16:51:38","slug":"peer-advisor-signup","status":"publish","type":"page","link":"https:\/\/www.bumc.bu.edu\/isep\/peer-advisor-signup\/","title":{"rendered":"Sign-Up Form for Peer Advisor Program for International Medical Students"},"content":{"rendered":"<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_6' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'>B.U. medical students may use this form to sign up to be peer advisor for an international medical student at BUSM.  Once your form is received, you will be contacted by Ana Gregory (anagreg@bu.edu) in the Enrichment Office.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/isep\/wp-json\/wp\/v2\/pages\/557' data-formid='6' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_6_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_6_1\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >1. Your 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_6_1'>\n                            \n                            <span id='input_6_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_6_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_6_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_2\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_2\"><label class='gfield_label gform-field-label' for='input_6_2' >2. Your e-mail address<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_2' id='input_6_2' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_6_10\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_10\"><label class='gfield_label gform-field-label' for='input_6_10' >3. What is your BUSM class year?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_6_10' type='text' value='' class='small' maxlength='4'    aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_6_3\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_3\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >4. When are you available (remotely and in person) to advise an international student? (check all blocks that you are available)<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_6_3'><li class='gchoice gchoice_6_3_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.1' type='checkbox'  value='No preference for dates'  id='choice_6_3_1'   aria-describedby=\"gfield_description_6_3\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_1' id='label_6_3_1' class='gform-field-label gform-field-label--type-inline'>No preference for dates<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.2' type='checkbox'  value='6\/28\/2019 - 7\/5\/2019 (block 10)'  id='choice_6_3_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_2' id='label_6_3_2' class='gform-field-label gform-field-label--type-inline'>6\/28\/2019 - 7\/5\/2019 (block 10)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.3' type='checkbox'  value='7\/26\/2019 - 8\/2\/2019 (block 11)'  id='choice_6_3_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_3' id='label_6_3_3' class='gform-field-label gform-field-label--type-inline'>7\/26\/2019 - 8\/2\/2019 (block 11)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.4' type='checkbox'  value='8\/23\/2019 - 8\/30\/2019 (block 12)'  id='choice_6_3_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_4' id='label_6_3_4' class='gform-field-label gform-field-label--type-inline'>8\/23\/2019 - 8\/30\/2019 (block 12)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.5' type='checkbox'  value='9\/20\/2019 - 9\/7\/2019 (block 13)'  id='choice_6_3_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_5' id='label_6_3_5' class='gform-field-label gform-field-label--type-inline'>9\/20\/2019 - 9\/7\/2019 (block 13)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.6' type='checkbox'  value='10\/18\/2019 - 10\/25\/2019 (block 14)'  id='choice_6_3_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_6' id='label_6_3_6' class='gform-field-label gform-field-label--type-inline'>10\/18\/2019 - 10\/25\/2019 (block 14)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.7' type='checkbox'  value='11\/15\/2019 - 11\/22\/2019 (block 15)'  id='choice_6_3_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_7' id='label_6_3_7' class='gform-field-label gform-field-label--type-inline'>11\/15\/2019 - 11\/22\/2019 (block 15)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.8' type='checkbox'  value='12\/13\/2019 - 12\/22\/2019 (block 16)'  id='choice_6_3_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_8' id='label_6_3_8' class='gform-field-label gform-field-label--type-inline'>12\/13\/2019 - 12\/22\/2019 (block 16)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.9' type='checkbox'  value='1\/17\/2020 - 1\/24\/2020 (block 17)'  id='choice_6_3_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_9' id='label_6_3_9' class='gform-field-label gform-field-label--type-inline'>1\/17\/2020 - 1\/24\/2020 (block 17)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.11' type='checkbox'  value='2\/14\/2020 - 2\/21\/2020 (block 18)'  id='choice_6_3_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_11' id='label_6_3_11' class='gform-field-label gform-field-label--type-inline'>2\/14\/2020 - 2\/21\/2020 (block 18)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.12' type='checkbox'  value='3\/13\/2020 - 3\/20\/2020(block 19)'  id='choice_6_3_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_12' id='label_6_3_12' class='gform-field-label gform-field-label--type-inline'>3\/13\/2020 - 3\/20\/2020(block 19)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_3_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.13' type='checkbox'  value='4\/10\/2020 - 4\/17\/2020 (block 20)'  id='choice_6_3_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_3_13' id='label_6_3_13' class='gform-field-label gform-field-label--type-inline'>4\/10\/2020 - 4\/17\/2020 (block 20)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_3'>The dates above represent the Friday before the start date (of an elective block) until the following Friday (the elective\u2019s first week).<\/div><\/li><li id=\"field_6_8\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_8\"><label class='gfield_label gform-field-label'  >5. How many international students are you able to advise (at one time)?<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_6_8'>\n\t\t\t<li class='gchoice gchoice_6_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='One international student'  id='choice_6_8_0'    \/>\n\t\t\t\t<label for='choice_6_8_0' id='label_6_8_0' class='gform-field-label gform-field-label--type-inline'>One international student<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='Two international students'  id='choice_6_8_1'    \/>\n\t\t\t\t<label for='choice_6_8_1' id='label_6_8_1' class='gform-field-label gform-field-label--type-inline'>Two international students<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_9\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_9\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >6. Are you interested in mentoring students from a particular country? Click all that apply or &quot;no preference&quot;<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_6_9'><li class='gchoice gchoice_6_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Pakistan'  id='choice_6_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_1' id='label_6_9_1' class='gform-field-label gform-field-label--type-inline'>Pakistan<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Egypt'  id='choice_6_9_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_2' id='label_6_9_2' class='gform-field-label gform-field-label--type-inline'>Egypt<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Greece'  id='choice_6_9_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_3' id='label_6_9_3' class='gform-field-label gform-field-label--type-inline'>Greece<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Israel'  id='choice_6_9_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_4' id='label_6_9_4' class='gform-field-label gform-field-label--type-inline'>Israel<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_9_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.5' type='checkbox'  value='Taiwan'  id='choice_6_9_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_5' id='label_6_9_5' class='gform-field-label gform-field-label--type-inline'>Taiwan<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_9_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.6' type='checkbox'  value='I have no preference.'  id='choice_6_9_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_9_6' id='label_6_9_6' class='gform-field-label gform-field-label--type-inline'>I have no preference.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_6\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_6\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >7. Click below to indicate that you understand the following requirement as a peer advisor:<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_6_6'><li class='gchoice gchoice_6_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='I understand I must contact my advisee (via e-mail) one week prior to the start date of his\/her elective (see block schedule link below)'  id='choice_6_6_1'   aria-describedby=\"gfield_description_6_6\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_6_1' id='label_6_6_1' class='gform-field-label gform-field-label--type-inline'>I understand I must contact my advisee (via e-mail) one week prior to the start date of his\/her elective (see block schedule link below)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_6_6'><p>> See <a href=\"http:\/\/www.bumc.bu.edu\/isep\/4th-year-block-dates\/\" target=\"_blank\">block \n  dates for 2019-2020<\/a><\/p>\n<p>&nbsp;<\/p>\n<li>\n<\/li><\/div><\/li><li id=\"field_6_7\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_7\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >8. Click below to indicate that you understand the following requirement as a peer advisor:<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_6_7'><li class='gchoice gchoice_6_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='I understand I must be available remotely and in person for the 8 days listed for the block that I selected. These dates represent the Friday before the start date (of an elective block) until the following Friday (the elective\u2019s first week).'  id='choice_6_7_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_7_1' id='label_6_7_1' class='gform-field-label gform-field-label--type-inline'>I understand I must be available remotely and in person for the 8 days listed for the block that I selected. 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