Forms

Forms
For all official experiences for academic credit, the following information and/or completed forms must be provided by the student (without exception and in observance of established timelines):

Short description (1 paragraph) of purpose of trip and what medical student hopes to gain from it, including statement of good academic standing. (pdf)
IDS paperwork (includes various signatures and 2-3 educational objectives). (pdf)
Hold harmless/liability waiver form (ECU version). (pdf)
Proof of health insurance.
Proof of emergency evacuation insurance.
Proof of travel clinic visit.
International certificate of vaccination form. (pdf)
Passport and/or (country specific) VISA.
Rotation evaluation form(s). (pdf)
If using official financial aid package to help fund trip, proof of visit with FA official at BSOM. (pdf)
Other forms required by various funding groups (e.g., scholarship fund forms).
ECU or BSOM "Student Discipline Pledge" form. (pdf)
Health Form or some version close to it (may be provided by travel clinic). (pdf)
Contact information form. (pdf)
Statement of participant responsibilities. (pdf)

Other forms and/or information may be required by various groups that furnish financial support. For information on any aspect of the process of completing these items, contact Dr. David Musick, Office of Medical Education (musickd@ecu.edu).