Lawrence S. Bloomberg Faculty of Nursing

NUR461 Primary Health Care: Nursing Perspectives in Global Health Placement Application

Form

Personal Information

Data Collected

• Form

  • Personal Information Statement - Please provide your consent
    • No
    • Yes, I agree with the statement above
    See Personal Information Statement Tab
    
    If you select No, you will not be able to continue with this form and you can discuss your options by contacting nursingplacementoffice@utoronto.ca.
  • You cannot continue with this form, please contact ask.nursing@utoronto.ca to discuss your options.
  • Name*
    First Last
  • University of Toronto email address*
    Enter Email Confirm Email
  • Do you speak any languages other than English and what are they?
  • Please respond to the following questions (limit 500 words)
  • How would you define global health?*
  • What previous experience have you had with international travel (as a tourist, with an NGO, or other)?*
  • Have you been involved in any work or volunteer capacity that would be relevant to a global health experience?*
  • What specific qualities or strengths could you bring to a nursing international placement?*
  • If you were successful in your application how do you anticipate you would respond to situations in which your own values and beliefs are not in alignment with something you hear or see during this placement.*
  • What do you think would be the biggest challenge for you of an experience such as this?*
  • What strategies have you used to help you manage the workload of the nursing program so far and how will you manage the additional challenges of such an opportunity in the midpoint of the term (including additional preparatory sessions prior to departure.)*
  • There are costs associated with travel and accommodation for this experience. Do you anticipate the financial burden of this experience will be manageable for you?*
  • What do you think would be your most significant learning arising from this international experience?*
  • What are you future goals in nursing?*
  • Please attach your CV*
    Max. file size: 8 MB.
  • Please attach a screen shot of your current ACORN transcript.*
    Max. file size: 8 MB.

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• Personal Information Statement

  The University of Toronto respects your privacy. The information on this form is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose of administering admission, registration, academic programs, university-related student activities, activities of student societies, financial assistance and awards, graduation and university advancement, and for the purpose of statistical reporting to government agencies. Your IP address and browser version are collected for Information Technology troubleshooting, as may be required. At all times, all data is protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please refer to www.utoronto.ca/privacy OR contact the

  University’s Freedom of Information and Protection of Privacy Office at 416 946-5835,
  Room 104, McMurrich Bldg.,
  12 Queen’s Park Crescent West,
  Toronto, ON, M5S 1A8.

  I agree to have the information in this form plus my IP address and browser version be collected and stored electronically and I understand it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. I understand that the information will be shared and viewed only by those who need to know. I also understand this form will be retained based on the University’s best practice guidelines for records retention, after which it will be destroyed in accordance with Information Technology Security best practices.

• Data Collected

  * Denotes a required field

  The following Data is collected on the form

  Personal information collection consent*

  First Name*

  Last Name*

  University of Toronto email address*

  Confirm Email*

  Do you speak any languages other than English and what are they?

  Please respond to the following questions (limit 500 words for each question)

  How would you define global health?*

  What previous experience have you had with international travel (as a tourist, with an NGO, or other)?*

  Have you been involved in any work or volunteer capacity that would be relevant to a global health experience?*

  What specific qualities or strengths could you bring to a nursing international placement?*
  If you were successful in your application how do you anticipate you would respond to situations in which your own values and beliefs are not in alignment with something you hear or see during this placement.*
  What do you think would be the biggest challenge for you of an experience such as this?*
  What strategies have you used to help you manage the workload of the nursing program so far and how will you manage the additional challenges of such an opportunity in the midpoint of the term (including additional preparatory sessions prior to departure.)?*
  There are costs associated with travel and accommodation for this experience. Do you anticipate the financial burden of this experience will be manageable for you?*

  What do you think would be your most significant learning arising from this international experience?*

  What are you future goals in nursing?*
  Attachments

  Please attach your CV*

  Please attach a screen shot of your current ACORN transcript.*

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  Other Data Collected

  This data is automatically collected by the system for the purpose of Information Technology administration and trouble shooting, as may be required and for summary-level only website statistical reporting:

  Browser Type

  Browser Version

  IP Address (does not identify you)

  Hardware and operating system (reported on an aggregate level)

  Country/city of origin (reported on an aggregate level)

  Session duration (reported on an aggregate level)

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