JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
MD+ Regional Community Director Application
Hello! We're so excited that you are interested in becoming a regional Launch Partner with MD++.
You can learn more about the role here:
https://docs.google.com/document/d/1ckqOn0KY91sQJr_UfDzSSNMCDtkVbTedEWUVsW0NH5Y/edit?usp=sharing
and see an example "Fall Agenda" here:
https://docs.google.com/document/d/1zmLn1jMm4a2PddFmeR6dqgn27VMncTNyQo0UQ__yeKA/edit?usp=sharing
* Indicates required question
Email
*
Your email
Option 1
Clear selection
Medical School
Your answer
City/State of medical school:
Your answer
Program and year (eg., MD/MBA MS2, or MD MS4)
Your answer
Why are you interested in becoming a Launch Partner? (about 100 words)
*
Your answer
Please list some of the health innovation opportunities or resources that are available to medical students in your school or region. (Bullet points are great)
Your answer
What resources or programming would be at the top of your agenda as a Launch Partner? (about 100 words)
Your answer
As a Launch Partner, you'll also be a member of the MD++ Community Committee. What ideas do you have for new community-wide initiatives?
Your answer
Can you commit to ~1 hour per week, and co-hosting ~1 event per month in terms of a time commitment?
*
Yes!
Maybe
Other:
Anything else you'd like to add, or any questions you have for us?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms