WC4BL 2022-2023 Listserv

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Hello! Thank you for your interest in being apart of White Coats for Black Lives at SSOM! Please complete the following to be added to the listerv. Please note all M4s will automatically be removed from the listserv at the end of the academic year. Take care.

Email *

First Name *

Last Name *

Phone number

Year in medical education / occupation - Please note all M4s will automatically be removed from the listserv at the end of the academic year *

Resident

Faculty

Staff

Community member

Other:

What information do you want to receive from the listserv?

How frequently do you want to receive a newsletter with events, resources and volunteer opportunities? *

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Other:

What programs do you want to see happen at SSOM as it relates to WC4BL?

Anything else you want to share with the Executive Board?

Send me a copy of my responses.

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