Working Group Survey

Working Group Interest Application

The NYSPHC Fellowship Program centers around three pillars: Promote, Connect and Enhance. The NYSDOH is convening a workgroup made up of Institutions of Higher Education (IHEs) across the state to inform decision-making around these Pillars.  
As part of the IHE workgroup, the NYSPHC would like to identify ways IHEs, NYSDOH, and community partners can work collaboratively towards a strengthened public health network. For more information on the NYSPHC Working Group, please visit our working group webpage.

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* 1. What Region would you like to represent in NY?

Capital District

Central NY

Finger Lakes

Long Island

Mid-Hudson

Mohawk Valley

New York City

North Country

Southern Tier

Western NY

Other (please specify)

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* 2. Please upload your Resume/CV

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 3. Do you have any previous experience with program promotion and planning? If so, please list:

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* 4. Do you have any previous experience in community collaboration and connection building? If yes, please elaborate:

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* 5. Please list any previous interdisciplinary work/collaboration with individuals from various professional backgrounds that you have contributed to:

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* 6. New York State is home to many diverse communities with varying needs. In which ways do you believe your personal and professional experiences would further the Public Health Corps's goal of diversity, equity, and inclusion (DEI)?