IEA Clinical Mentee Sign-Up: Fall 2017
The IEA Footstep Buddy program seeks to match up students entering their clinical years with mentors that can provide tips, advice, pertinent information to support a successful transition from the basic sciences.

For any questions please send us an e-mail at iea.sgu@gmail.com.

Last Name *
Your answer
First Name *
Your answer
Preferred E-mail Address *
Your answer
Preferred Phone Number
Your answer
State
that you hope to do clinical rotations in (optional)
Your answer
City
that you hope to do clinical rotations in (optional)
Your answer
Hospital System
that you hope to do clinical rotations in (optional)
Your answer
Hospital
that you hope to do clinical rotations in (optional)
Your answer
Who was your 5th term IEA President?
Clinicals Start Date
MM
/
DD
/
YYYY
What specialty are you considering?
Your answer
Would you like to be matched with someone considering the same specialty?
In which rotations do you wish to be mentored? *
Required
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