Submit Medical Student Service Leadership Project Grant

Project Information

Title of project *

Please enter title.

Student Leader Information

First Name *

Please enter first name.

Last Name *

Please enter last name.

Member Number If s/he is a member, please enter the member id. See "Member Search" at left sidebar

Street 1 *

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Street 2

City *

Please enter city.

State *

Please select state.

Zip *

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Country *

Please select country.

Email Address *

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School Information

School/Chapter *

Please select a chapter.

Councilor *

Please select a councilor.

Project Members Information

Project Member

Role

First Name

Last Name

Member Number If s/he is a member, please enter the member id. See "Member Search" at left sidebar

Street 1

Street 2

City

State

Zip

Country

Email Address

Submission

Instructions:

Files must be submitted in one PDF in the following order:

Completed Checklist.
Four-page summary with project description, budget and role of students in project preparation and execution.
Description of team, team leaders, and leadership components.
Description of AΩA chapter role in project.
Description of role of faculty mentor/advisor and leadership curriculum for students.
Letter of support from faculty mentor(s)/advisor(s).
Faculty mentor biosketch(es).
Letter of endorsement from AΩA Councilor.
Letter of endorsement from Dean.
Commitment of matching funds by Dean or school.

File *

Please include file.

"Be worthy to serve the suffering."

-William W. Root, MD - Founder, 1902

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