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Register your National Service Project event

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Please complete the entire application.

The information you provide below is solely for the AMA's internal use and will not be reused or sold for any commercial purposes without your permission. We are collecting this information to better publicize your event and may use it in AMA promotions, media, etc.

*Asterisk indicates required field

*Medical School

Contact Person
*First Name

*Last Name

*City

*State

*ZIP code

*Phone #

*E-mail Address

Your e-mail address will not be shared, sold, traded, exchanged, or rented. See our Privacy Policy for more information.

*Title of event

*Date of event
         

*Event description (this brief description will be used for advertisement on the Health Access Web site)

Thank you for informing us of your event.

Last updated: Jul 18, 2007
Content provided by: Medical Student Section