Department of Community and Preventive Medicine

Environmental and Occupational Health Summer Program

Application for Summer Training in Environmental Health Research at
Mount Sinai School of Medicine

Last Name
First Name
E-mail Address

Address
City
State
Zip

Phone Number
Best Time of day to call

Current Medical School
Year of Medical School
College attended
Year graduated
Major

Did you work after college for more then one summer before starting
medical school?
Yes No
If yes, what did you do?

Have you done any work in environmental or occupational health,
epidemiology, public health or the like?
Yes No
If yes, what did you do?

Have you ever done any research?
Yes No


What dates would you be available for the summer traineeship? It should take
8-10 weeks.
From

To


Please enter a brief statement of your interest in participating in this summer research program.

All information above will be electronically distributed when you hit the submit button below. Applicants may be contacted by Dr. Szeinuk by phone prior to acceptance into the program.