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AMSA's Local Project Submission Form
CONTACT INFORMATION
Chapter:
Select a Chapter
*At Large Medical - Chapter Not Listed
AT Still Univ School of Osteopathic Medicine in Arizona
Albany Medical College
Albert Einstein COM of Yeshiva University
Arizona College of Osteopathic Medicine
Baylor COM
Boonshoft SOM at Wright State University
Boston University SOM
Brody SOM at East Carolina University
CCNY Sophie Davis School of Biomedical Education
Campbell University School of Osteopathic Medicine
Case Western Reserve University SOM
Columbia University College of Physicians & Surgeons
Cooper Medical School of Rowan University
Creighton University SOM
Dartmouth Medical School
David Geffen SOM At UCLA
Des Moines University College of Osteopathic Medicine
Drexel University COM
Duke University SOM
Eastern Virginia Medical School
Edward Via Virginia College of Osteopathic Medicine
Emory University SOM
Florida Atlantic University Charles E. Schmidt COM
Florida International Univ Herbert Wertheim COM
Florida State University COM
George Washington University SOM and Health Sciences
Georgetown University SOM
Georgia Health Sciences Univ Medical College of Georgia
Harvard Medical School
Hofstra North Shore - LIJ School of Medicine
Howard University COM
Indiana University SOM
Jefferson Medical College
Johns Hopkins University SOM
Kansas City Univ College of Osteopathic Medicine
Keck SOM of Univ of Southern California
Kirksville College of Osteopathic Medicine
LSU Health Sciences Center SOM in Shreveport
Lake Erie College of Osteopathic Medicine
Lake Erie College of Osteopathic Medicine - Bradenton
Lincoln Memorial Univ-DeBusk College of Osteopathic Medicine
Loma Linda University SOM
Louisiana State University SOM at New Orleans
Loyola University Chicago Stritch SOM
Marshall University Joan C Edwards SOM
Mayo Medical School COM
McGill FOM
Medical College of Wisconsin
Medical University of South Carolina COM
Meharry Medical College SOM
Memorial University of Newfoundland FOM
Mercer University SOM
Mercer University SOM Savannah
Michigan State University CHM
Michigan State University College of Osteopathic Medicine
Midwestern Univ Chicago College of Osteopathic Medicine
Morehouse SOM
Mount Sinai SOM
New York College of Osteopathic Medicine
New York Medical College
New York University SOM
Northeast Ohio Medical University
Northwestern University Feinberg SOM
Nova Southeastern Univ College of Osteopathic Medicine
Oakland University William Beaumont SOM
Ohio State University COM
Ohio University College of Osteopathic Medicine
Oklahoma State Univ CHS College of Osteopathic Medicine
Oregon Health & Science Univ SOM
Pacific Northwest Univ of HS College of Osteopathic Med
Paul L Foster SOM at Texas Tech Univ Health Sciences Center
Penn State Hershey COM
Philadelphia College of Osteopathic Medicine
Philadelphia College of Osteopathic Medicine - Georgia
Pikeville College School of Osteopathic Medicine
Ponce SOM
Quillen COM East Tennessee State University
Rocky Vista Univ College of Osteopathic Medicine
Rosalind Franklin University of Medicine and Science
Rush Medical College
SUNY Downstate Medical Center COM
SUNY Upstate Medical University COM
Saint Louis University SOM
San Juan Bautista SOM
Sanford SOM University of South Dakota
Southern Illinois University SOM
Stanford SOM
Stony Brook SOM
Temple University SOM
Texas A&M Health Science Center COM
Texas Tech University HSC SOM
The Commonwealth Medical College
Touro College of Osteopathic Medicine (NY)
Touro Univ College of Osteopathic Medicine (CA)
Touro Univ Nevada College of Osteopathic Medicine
Tufts University SOM
Tulane University SOM
UMDNJ New Jersey Medical School
UMDNJ RWJ Medical School At Camden
UMDNJ Robert Wood Johnson Medical School
UMDNJ School of Osteopathic Medicine
Uniformed Services Univ of HS F Edward Hébert SOM
Universidad Central del Caribe SOM
University At Buffalo SOM & Biomedical Sciences
University of Alabama SOM
University of Alberta FOM & Dentistry
University of Arizona COM
University of Arizona COM - Phoenix
University of Arkansas for Medical Sciences COM
University of British Columbia FOM
University of Calgary FOM
University of California, Davis SOM
University of California, Irvine SOM
University of California, Riverside SOM
University of California, San Diego SOM
University of California, San Francisco SOM
University of Central Florida COM
University of Chicago Pritzker SOM
University of Cincinnati COM
University of Colorado SOM
University of Connecticut SOM
University of Florida COM
University of Hawaii At Manoa John A Burns SOM
University of Illinois COM at Chicago
University of Illinois COM at Peoria
University of Illinois COM at Rockford
University of Illinois COM at Urbana-Champaign
University of Iowa Carver COM
University of Kansas SOM
University of Kansas SOM-Wichita
University of Kentucky COM
University of Louisville SOM
University of Manitoba FOM
University of Maryland SOM
University of Massachusetts Medical School
University of Miami Miller SOM
University of Michigan Medical School
University of Minnesota Medical School
University of Minnesota Medical School – Duluth
University of Mississippi Medical Center SOM
University of Missouri - Kansas City SOM
University of Missouri SOM
University of Nebraska Medical Center COM
University of Nevada SOM
University of New England College of Osteopathic Medicine
University of New Mexico SOM
University of North Carolina SOM
University of North Dakota SOM & Health Sciences
University of North Texas College of Osteopathic Medicine
University of Oklahoma COM
University of Oklahoma-Tulsa School of Community Medicine
University of Ottawa FOM
University of Pennsylvania SOM
University of Pittsburgh SOM
University of Puerto Rico SOM
University of Rochester Medical Center SOM & Dentistry
University of Saskatchewan COM
University of South Alabama COM
University of South Carolina SOM
University of South Carolina SOM Greenville
University of South Florida Morsani COM
University of Tennessee COM
University of Texas HSC at San Antonio SOM
University of Texas Medical Branch SOM
University of Texas Medical School at Houston
University of Texas Southwestern Medical School
University of Toledo COM
University of Toronto FOM
University of Utah SOM
University of Vermont COM
University of Virginia SOM
University of Washington SOM
University of Wisconsin SOM and Public Health
Vanderbilt University SOM
Virginia Commonwealth University SOM
Virginia Tech Carilion SOM
Wake Forest University SOM
Warren Alpert Medical School of Brown Univ
Washington University in St Louis SOM
Wayne State University SOM
Weill Cornell Medical College
West Virginia School of Osteopathic Medicine
West Virginia University SOM
Western Univ College of Osteopathic Medicine of the Pacific
William Carey Univ College of Osteopathic Medicine
Yale University SOM
Project coordinator:
Coordinator's email:
PROJECT DESCRIPTION
Project Type(s)
Select all that apply.
Community Service
Fundraiser
School Service
Social Event
Speaker
Recruitment
Rally
Lobby Event
Other
Project title:
Date of completion:
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2011
2010
2009
Summary of project:
Content area:
Select all that apply.
Business of Medicine
Child and Adolescent Health
Community and Environmental Health
Complementary/Alternative Medicine
Creative Expression
Culture of Medicine
Death and Dying
Disabilities
Disparities
Diversity in Medicine
Education
Election Reform
Environmental Health
Family Violence
Gender and Sexuality
Geriatrics
Global
Grassroots Leadership
Health Care for All
Health Fair
HIV/AIDS
Human Rights
Humanistic Medicine
LGBT Health
LGBT People in Medicine
Medical Specialties
Mental Health
Military Medicine
Minority Affairs
National Primary Care Week
Naturopathic Medicine
Neurology
Osteopathic Medicine
PharmFree
PDAs
Pharmaceutical Issues
Policy
Primary Care
Preventive Medicine
Professionalism
Race, Ethnicity and Culture in Health
Resident Work Hours
Student Debt
Student Life
Student-Run Clinic
Substance Abuse
Surgery
Wellness/Well-Being
Womens Health
Other
Number of attendees:
People
Duration of event:
Hours
Round to the nearest hour and do not include text in your answer
PROJECT PLANNING
Project coordinator roles:
Total coordinator hours:
Hours
Round to the nearest hour and do not include text in your answer
FUNDING
Total cost of project:
How was the project funded?
Select all that apply.
Local chapter funds
School funds
AMSA grant
Other grant (clarify in funding breakdown box below)
Donation
Admission/participant charge
Please describe the breakdown of your sources of funding and/or donations:
ADVERTISING
How was the project advertised? Did it work?
PROJECT EVALUATION
How would you rate the success of your project?
- Select one -
1 unsuccessful
2
3
4
5 very successful
Lessons & suggestions: What could have been done to improve the project? What should others know to replicate this?
ADDITIONAL COMMENTS
Any additional comments that may benefit a chapter in completing a similar project would be greatly appreciated.