"Be worthy to Serve the Suffering" Alpha Omega Alpha Honor Medical Society Key Background

Medical Student Service Leadership Project

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Title of project *
* Salutation
Student Leader First Name *
Student Leader Last Name *
Student Leader Member ID (If s/he is AΩA member, please enter the member id. See “Locate a Member” at left sidebar.)
Student Leader Email *
Student Leader Street 1 *
Student Leader Street 2
Student Leader City *
Student Leader State *
Student Leader Country *
Student Leader Zip *

School
* Councilor
Role
First Name
Last Name
Member ID (If s/he is AΩA member, please enter the member id. See “Locate a Member” at left sidebar.)
Email
Street 1
Street 2
City
State
Country
Zip
File
Note: Files must be submitted in one PDF in the following order:
1. Completed Checklist
2. 4 page summary with project description, budget and role of students in project preparation and execution
3. Description of team, team leaders, and leadership components
4. Description of AΩA chapter role in project
5.Description of role of faculty mentor/advisor and leadership curriculum for students
6. Letter of support from faculty mentor(s)/advisor(s)
7. Faculty mentor biosketch(es)
8. Letter of endorsement from AΩA Councilor
9. Letter of endorsement from Dean
10. Commitment of matching funds by Dean or school