SLICC Membership Sign-up
Welcome to SLICC, a community that values connection and relationships, and strives to amplify the student voice and experience in medical education innovation and curriculum reform.

We've been hard at work growing our network in order to better serve you--students and learners around the world! But now we need your help! Please share your information and interests below - the information collected in this form will allow us to get to know you better and help facilitate connections, collaborations, and conversations among our members.

A note on Privacy: Your information will only be used for SLICC-related activities and will not be shared with any other individuals, groups, or institutions without your consent. If you ever want your information updated or removed from our database, please send us an email at sliccedu@gmail.org and we'll take care of it for you.

First Name *
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Last Name *
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Email (School/Program) *
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Email (Personal)
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Expected or Past Graduation Date *
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Name of your School/Program *
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Location of your School/Program (city, state, country)
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How would you like to be involved with SLICC? *
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What services from SLICC have you appreciated so far? *
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What other resources or activities would you like to see from SLICC?
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