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Application for calendar year 2023 clinical experiences.

Applications for 2023 clinical experiences will close at 11:59 PM EST on Tuesday, May 31, 2022. We expect that final placement decisions will be made by Thursday, July 15, 2022 with all successful applicants being notified shortly after.

Please reach out to info@edgulobalassociates.org with any questions about your individual circumstances.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Gender: How do you identify?

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* 4. In what year were you born? (enter 4-digit birth year; for example, 1976)

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* 5. In what state or U.S. territory do you live?

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* 6. In what city do you live?

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* 7. At what email address would you like to be contacted?

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* 8. At what phone number would you like to be contacted?

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* 9. What is the name of your DPT school/university/college?

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* 10. What is the name of your schools Director of Clinical Education (DCE)?

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* 11. What is the email address of your schools DCE?

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* 12. How long is your DPT Program?

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* 13. Which year of your DPT program are you currently in?

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* 14. How many clinical experiences will you complete in your time in DPT program?

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* 15. How many clinical experiences would you have completed prior to beginning a clinical experience in Europe?

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* 16. What level of clinical experience would you be looking to complete in Europe?

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* 17. How many weeks in length would you like your clinical experience to be?

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* 18. What is your preferred clinical setting? (Mark all that apply)

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* 19. Do you have a preferred facility?

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* 20. Are you willing to split your clinical experience between two facilities?

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* 21. On what date would you like to begin your clinical experience?

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* 22. On what date would you like to end your clinical experience?

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* 23. Are your dates flexible?

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* 24. Do you have alternative dates you can provide?

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* 25. On what alternative date would you like to begin your clinical experience?

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* 26. On what alternative date would you like to end your clinical experience?

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* 27. Do you have a passport?

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* 28. If you have a passport, is it from the United States or from another country?

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* 29. Have you ever traveled overseas before?

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* 30. Briefly describe your reasons for wanting to complete a clinical experience in Europe?

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* 31. Are you willing to adhere to all set, local, federal and international guidelines related to COVD-19 and to all policies in procedures in the Eduglobal student Handbook?

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* 32. Is your DCE aware that you are applying to this program?

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