Citizen Physicians Interest Form
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School *
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Current Year in School *
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Phone Number *
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I am interested in *
If you will be participating in the National Medical Student Voter Registration Campaign (either as a one-time event or as a formal chapter), please fill out the following information:
How many pins would you like? (The number of people actively organizing the voter registration campaign).
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What address should we send the pins to?
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Thank you for expressing interest in Citizen Physicians. We'll reach out to you shortly.
Any questions or comments?
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