Citizen Physicians Interest Form
Current Year in School
I am interested in
Starting a chapter of Citizen Physicians at my school
Organizing a voter registration drive at my school as part of the National Medical Student Voter Registration Campaign
I'm not sure and I'd like to talk more about it with Citizen Physicians' Executive Director
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).
What address should we send the pins to?
Thank you for expressing interest in Citizen Physicians. We'll reach out to you shortly.
Any questions or comments?
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