Clerkship Online Application


Application to Participate in Medical and Public Health Student Internship in Yun Nan Province, China. China California Heart Watch (China Cal) This is an oppurtunity to obrain first hand experience of medical problems and care in the impoverished communities of rural Yunnan Province and Kunming city. This is not a vacation. Students will participate and help in clinical care and research in impoverished areas of Yunnan Province. To participate you must be qualified. Please answer the follwing questions. Click submit, then print, sign and email the waiver when prompted. Applications will not be considered until a signed waiver is received by China Cal Name (as in passport): Phone Number: Email: Passport Country: Passport Number: We will need your passport info to register you with the local government departments and to help you get your visa. Address: 1.) Do you speak mandarin? If so, is your Mandarin (a) elementary (can ask directions in the street but cannot converse with others and cannot read), (b) intermediate (can carry on casual conversation and can read a little), (c) advanced (fluent, can teach and read well). 2.) If you participate, how will this help you in your avowed career? 3.) What is your academic level (undergrad, grad student, other)? 4.) What is your specialty/major (medicine, public health, social work, psychology, etc)? 5.) Please write a paragraph describing your career goals? 6.) When will you be available for a phone interview with either Dr. Wong or Dr. Detrano? ( mm/dd/yyyy ) 7.) Which dates will you be available for attending our internship? December 12/11-12/29 Thank you. Please click Submit below. Print the waiver on the following page. Sign and email the signed waiver to robert@chinacal.org. Applications will not be reviewed until a signed waiver is received.

Application to Participate in Medical and Public Health Student Internship in Yun Nan Province, China.

China California Heart Watch (China Cal)

This is an oppurtunity to obrain first hand experience of medical problems and care in the impoverished communities of rural Yunnan Province and Kunming city. This is not a vacation. Students will participate and help in clinical care and research in impoverished areas of Yunnan Province.

To participate you must be qualified. Please answer the follwing questions. Click submit, then print, sign and email the waiver when prompted. Applications will not be considered until a signed waiver is received by China Cal

Name (as in passport):
Phone Number:
Email:

Passport Country: Passport Number:
We will need your passport info to register you with the local government departments and to help you get your visa.

Address:

1.) Do you speak mandarin? If so, is your Mandarin (a) elementary (can ask directions in the street but cannot converse with others and cannot read), (b) intermediate (can carry on casual conversation and can read a little), (c) advanced (fluent, can teach and read well).

2.) If you participate, how will this help you in your avowed career?

3.) What is your academic level (undergrad, grad student, other)?

4.) What is your specialty/major (medicine, public health, social work, psychology, etc)?

5.) Please write a paragraph describing your career goals?

6.) When will you be available for a phone interview with either Dr. Wong or Dr. Detrano?
( mm/dd/yyyy )

7.) Which dates will you be available for attending our internship?

December 12/11-12/29

Thank you.

Please click Submit below. Print the waiver on the following page. Sign and email the signed waiver to robert@chinacal.org. Applications will not be reviewed until a signed waiver is received.