AMSA Internship and Research Committee Application1 by fDQ7Zq


									                        Research and Internship Committee Application
Name: __________________________________________ Classification: _________________

E-mail: _________________________________________ National AMSA Member?:                                     Yes     No

Current Semester Hours: _________________                   Total Semester Hours: __________________

Personal Contact Number*: ______________________________ Major: __________________
*Necessary for notifying accepted applicants if e-mail is not an option or a non-responded email.

Open Ended Response: On a separate sheet of paper, please respond to the following questions:

1. List any previous leadership, academic commitments, internships, or research experience.

2. Describe yourself with no more than 5 adjectives.

3. What goals have you set for AMSA? For the Research and Internship Committee?

4. Are you involved in any other academic or non-academic organizations? Please list all.

5. For what reasons have you decided to run for the AMSA Research and Internship Committee?

6. In your own words, why do you believe research and/or internship opportunities are important
to the undergraduate education?

Applications will be due 5:00 P.M. Tuesday, September 11th, 2012 in the BSB Room D. 108
Medical Humanities Office. Accepted and rejected applicants will be contacted via e-mail
(phone if necessary). Interview dates and room numbers are TBA and will be e-mailed to
applicants at least 48 hours in advance of scheduled time.

By signing below, I hereby agree all information provided above remains in respect to the truth. False statements,
plagiarism, and disclosure of the interview process may cause the disqualification of my application.

Signature: ________________________________________                         Date: ____________________

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