White Coat Sponsorship Program

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in supporting our students through the White Coat Sponsorship Program. Your gift will directly support financial aid at Cummings School and your words of wisdom will help motivate and inspire Class of 2025 students as they prepare to join you in the profession.

Please enter responses for the fields below. Your note will be given to a third year student during their White Coat ceremony.

Email *

Your First Name: *

Your Last Name: *

Class Year: *

Would you like us to include your email address in the student's note? *

My message for a third-year student is ... *

Thank you so much for honoring our third-year students as they enter clinical rotations and begin to apply their knowledge and skills through hands-on patient care. Your support is greatly appreciated!

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms