Medical School Duluth Student Experience Award
Please use this form to apply for funding for conference fees, traveling costs and educational experiences that require assistance in funding. This award may be awarded only once to you and the maximum amount awarded is $500.00. Request for funding must be for an experience that relates to our medical school mission. Please request funding at least 30 days prior to the need, special circumstances may be made under request. Funding is available for 1st and 2nd year medical students at the Duluth Campus.
First Name *
Your answer
Last Name *
Your answer
Email: *
Your answer
Telephone Number *
Your answer
Year in Medical School *
Your answer
Which conference are you going to?
Your answer
Will you be presenting at this conference?
Please include abstract if available or a short description.
Your answer
Have you received funding before for a student experience? Are there other funding sources available for you for this experience? *
Please be detailed
Your answer
Please give us the details of why you are requesting funding. *
Your answer
Amount of funds requested? *
Your answer
May we publish your participation/presentation in Medical School related news? *
Submit
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