Form

Please email Claire at claire.sabers@medicalbrigades.org with any questions or concerns.

Demographic Information

First name*

Last name*

Personal Pronouns*

Email*

Phone number*

City*

State/Region*

GB Entity (USA, Canada, UK)*

University

State / Province

Qualifications

As a Campus Chairperson, one of your core responsibilities is to unite the chapters on your campus. Because of this, it is important that we understand how Global Brigades is structured on your campus.

What is the structure of Global Brigades on your campus?*

Please briefly describe what chapters are active and how they work together on campus. Include details like your leadership structure, meeting structure and frequency, etc.

Please describe your experinece with Global Brigades, including brigades you have attended, leadership positions you have held, and other roles you have played.*

What other experiences outside of Global Brigades have prepared you for this position?*

Examples: leadership experience, club participation, fundraising, team building, etc.

Tell us 3 goals you have for yourself/your campus as Campus Chairperson for the next year. Be as detailed as possible. (I.e. Grow Volunters, unite Chapters, engage a new Chapter Leader?)

We will use these goals to track progress and to take into consideration for your CC scholarship.

What year are you expected to graduate?

Chapter President Endorsements

An important aspect of the CC application process is receiving endorsements/nominations from each of the chapter presidents on your campus. Given that the CC will be representing your campus, and thus, all Chapters on your campus, it is very important that you are supported by each chapter leader on your campus. Please provide the names/email addresses of each chapter president (e.g., medical president, water president, etc.).

By providing names and email addresses of Chapter Leaders on campus, you are confirming that they endorse you as CC.

NOTE: Given that the role of the CC is to grow Global Brigades holistically on their campus, it is strongly recommended that you have at least 3 active chapters on your campus. However, if you have 1 or 2 and are actively working on creating a third, please let us know!

Outgoing CC Nomination

Medical Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Medical Chapter on your campus simply write N/A

Dental Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Dental Chapter on your campus simply write N/A

Public Health Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Public Health Chapter on your campus simply write N/A

Water Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Water Chapter on your campus simply write N/A

Engineering Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Engineering Chapter on your campus simply write N/A

Business Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Business Chapter on your campus simply write N/A

Legal Empowerment Chapter President Nomination

Example: John Smith (johnsmith@gmail.com). If there is not a Legal Empowerment Chapter on your campus simply write N/A

Are you planning on starting a New GB Chapter this year?

If so, please include here the type of chapter and who will be the Chapter Leader / main point of contact!