AMSA Recruitment Order Form

School Name & Location:	Medical  Premedical  International
Entering Class Size:	(medical chapters only)
Orientation Date:

Recruitment Plans:

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BULK SHIPMENT: Mandatory

Please ship below items by .
This is the LATEST date you would like to receive materials before orientation. If no date is indicated, materials will be shipped approximately 2 weeks prior to orientation date. Please be sure you will be at the address you indicate for delivery at that time.

Ship to:

Name	AMSA ID#
Address	(NO PO Box #s - UPS does NOT deliver to PO Boxes)
City, State Zip
Country	(for non-USA addresses)
Phone	(please include)
Email

Please indicate the quantities you will need:

AMSA membership brochure/application	Qnty.
National President's Letter	Qnty.
Health Insurance Brochures Address will be forwarded and these brochures will be shipped directly from the insurance carrier to the name listed above	Qnty.
The bulk shipment will include sample benefit brochures for display. Once membership applications are received and processed, new members will receive the AMSA Benefits Packet which will include applications/brochures for all our benefits and services.

WELCOME MAILING: Recommended (medical chapters only)

Medical chapters can have AMSA send a direct welcome mailing to incoming students. This includes AMSA's National President's letter and membership application. (If your chapter is participating in the MBNA gift promotion, notification about the program will be included instead of the membership application.)

A local chapter letter can also be included.  All letters must be approved by the National Office prior to distribution. Email local chapter letters to Vicki Martel at vmartel@amsa.org for approval. Examples of letters can be found in the COC handbook online at http://www.amsa.org/coc/recruitment.pdf.

The local chapter will send names and addresses of the incoming class on adhesive labels, to the National Office by .

AMSA National should mail materials by (allow 1-2 weeks for preparation).

Indicate if you do not want these names and addresses used to promote other AMSA services and benefits.

You may also print out this form and mail it to AMSA Membership, 1902 Association Drive, Reston, VA 20191. All orders must be submitted by June 30, 2008. You may also call 1-800-767-2266 to place your order by phone.