Exit 2019 MSSCE & RREMS Site Sponsor Application Question Title * 1. Please provide the following information: Contact Person: * Name of Institution: * Address: * City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Contact Email: * Contact Phone: * Question Title * 2. URL of department website: Select which program(s) you would like to serve as a site sponsor for in 2019. You may select either one or both of the programs. Question Title * 3. Program Selection Medical Student Summer Clinical Experience (MSSCE) Rehabilitation Research Experience for Medical Students (RREMS) Question Title * 4. We are willing to host the following number of students for 2020: MSSCE RREMS Total # of students we can host Provide the Name(s) and Academic Position(s) of proposed mentors. Question Title * 5. MSSCE Mentors: Question Title * 6. RREMS Mentors: RREMS Sites Only - Describe current research efforts/opportunities that may be applicable for a summer externship project. Question Title * 7. Current research areas/projects: Question Title * 8. We agree to support all travel, hotel and registration costs to the 2020 AAAP meeting for student(s) placed at our site. Yes Done