The National Medical Student Voter Registration Campaign
Sign up here if you are interested in getting more information about the National Medical Student Voter Registration Campaign and how to receive a Citizen Physicians pin*.
Name *
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Email *
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Phone
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Medical School (official school name), City, State *
Your answer
Year in medical school *
Address to send the pins to *
Your answer
How many pins do you need (1, or are you organizing this with other classmates)? *
Your answer
Any questions or comments?
Your answer
Thank you
Within a week of submitting this form, you will receive an email with more information. In the meantime, please make sure to visit our website at www.citizenphysicians.org, like us on facebook to keep up to date, and follow us on twitter @ctznphysicians.

*Pins available while supplies last (but don't worry: we have a lot).

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