ACOI Student of the Month

ACOI would like to recognize Student Osteopathic Internal Medicine Association (SOIMA) members who demonstrates a commitment to osteopathic internal medicine through community service, leadership, achievements in research, educational development, and personal achievement by highlighting students in the ACOI Student of the Month program.  Please use the below form to nominate a student who has been an outstanding member of your community.  We look forward to recognizing these students!

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Name of Student Nominee: *
Nominee's College of Osteopathic Medicine: *
Nominee's Current Academic Year: *
Nominee's Email and Cell Phone Number *
Please describe why your nominee should be an ACOI Student of the Month. (3000 character maximum) *
Nominator's Name: *
Nominator's Email and Cell Phone: *
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