SIM Challenge Regional Competition Application
Please fill out the following information to apply to host a regional SIM Challenge at your school. To host a regional event, the following conditions apply:

1. Host school must provide proof of faculty advisor support for the event.
2. Host school will select the cases/scenarios for the competition.
3. Cases must be approved by host school faculty.
4. Host school must provide three judges for the event.
5. Host school must reserve space for the event.
6. Regional competitions must include teams outside of the host school.

Full Name *
Your answer
Email Address *
Your answer
AMSA ID (Your AMSA ID can be found at https://www.amsa.org/get-amsa-id/) *
Your answer
Medical School/Training Institution *
Your answer
Faculty Advisor Name *
Your answer
Faculty Advisor Email *
Your answer
Proposed Date of Event *
MM
/
DD
/
YYYY
Proposed Location (event space) *
Your answer
Judge Names and Emails (separate by commas) *
Your answer
Other Schools Participating *
Your answer
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