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Regional SIM Challenge Team Application
Teams who want to compete in a regional competition must complete the following:
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* Indicates required question
Regional Challenge Location (Host School Name)
*
Your answer
Date of Regional Challenge
*
MM
/
DD
/
YYYY
Team Medical School/Training Institution
*
Your answer
Team Name
*
Your answer
Full Name and AMSA ID for all Team Members (separate by commas)
*
Your answer
Email Addresses for all Team Members (separate by commas)
*
Your answer
Faculty Advisor Name
*
Your answer
Faculty Advisor Email
*
Your answer
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