Fall Honors Convocation - Student Information Sheet

The Prizes and Awards Committee usually meets during the Fall semester to select award recipients/nominees for the Fall Honors Convocation which will be held this year on Friday, November 20, 2009. Award selections may be based on academic achievement however, it is not the only criteria used - leadership, service to the community, service to the medical school, and extracurricular activities are considered as well.

Name (Required)

Class of (graduation year) (Required)

Your E-Mail Address (Required)

Awards/Honors/Scholarships

Please list your most recent awards/honors/scholarships received in while in medical school and the dates your received them. (DO NOT ABBREVIATE)

Medical School Committees &/or Offices

List your most recent medical school committee memberships and/or offices. Please list dates of service and describe your level of involvement. (DO NOT DUPLICATE IF LISTED ELSEWHERE ON THIS FORM)

Student Organizations &/or Service Activities

List your most recent memberships in student organizations and/or service activities and dates of membership/service for the university community while in medical school. Please describe your level of involvement with organization/activity. (DO NOT DUPLICATE IF LISTED ELSEWHERE ON THIS FORM)

Community Activities &/or Services

List your most recent community activities and/or services and dates of service while in medical school. Please describe your level of involvement with the activity/service. (DO NOT DUPLICATE IF LISTED ELSEWHERE ON THIS FORM)

Publications, Grants, Presentations, etc.

List most recent publications, grants, presentations, etc. while in medical school.

Additional Information &/or Comments

Deadline is Friday, Octopber 2, 2009

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Fall Honors Convocation - Student Information Sheet

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