Haku Healthcare American Indian Student Summit Event Registration
Event Timing: March 30, 2019 from 8:00am - 6:00pm
Event Address: Santa Ynez Chumash Tribal Hall, 100 Via Juana Lane, Santa Ynez, CA 93460
Contact Dr. Stern at
for any questions.
Age (as of March 30, 2019)
College Major or Career Focus?
What is your grade or college/university level?
Are you able to attend the full day 8am-6pm?
No, just the morning only, 8am-12pm
No, just the afternoon only, 1:30pm-6pm
Dietary restrictions (if any)?
I understand that registration is FREE (includes breakfast, breaks and lunch), but I will have to make my own arrangements regarding travel or lodging (if necessary).
FOR PRE-HEALTH CARE CAREER/PRE-PUBLIC HEALTH/COLLEGE STUDENTS/EARLY CAREER STUDENTS ONLY: Write a 400 word maximum paragraph about why you would like to attend the Haku Healthcare American Indian Student Summit.
FOR MEDICAL STUDENTS ONLY (check all that apply):
I will attend and my institution is sponsoring my attendance.
I would like to attend but need assistance with travel and/or lodging (email Dr. Stern).
I will attend and do not require any sponsorship (i.e. driving in for the day).
I am an ANAMS member and would like to attend the mentoring dinner March 30th.
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