MOLA's IHG member application
Bienvenido! 
This group is part of the MOLA Mentorship Program with the scope of provide support and guidance to future applicants, seeking a career in healthcare in the USA. This short survey will let us know more about you and your interests.
After the completion of the survey, you would be directed to a link to join our WhatsApp group
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Email *
Full name
Tell me about yourself (aspirations, interests, extracurriculars, work) *
Do you have ideas of a project you would like to work on, for the committee? Please explain *
Country  *
State and city ( If currently in the USA) *
Medical School *
Specialty of interest *
Are you a MOLA member? *
Have you finalized any of the following? *
Required
Do you have experience giving educational webinars? If yes, please tell me about your experience *
Would you like to be a volunteer? *
If you are interested in being a volunteer, please select which of our 4 principal branches are you interested in *
Required
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