AMIA 2021 Annual Symposium Student Volunteer Application Question Title * 1. Full name Question Title * 2. Email address Question Title * 3. School or Fellowship Program attending Question Title * 4. Are you a current AMIA Student Member? (You must be a current AMIA member in order to qualify for participation in this program) Yes No Question Title * 5. Have you ever been an AMIA student volunteer before? Yes No Question Title * 6. Are you an author or presenter at the AMIA 2021 Annual Symposium? Yes No Question Title * 7. Is your academic informatics program supporting your travel and lodging? Fully Partially Not at all Question Title * 8. Do you have other funding to support travel and lodging? Yes No Not sure Question Title * 9. Please describe why you want to be a student volunteer and how being selected would help you attend the AMIA conference. Question Title * 10. PLEASE READ AND ACKNOWLEDGEI understand that to participate in the AMIA Student Volunteer Program I will be responsible for monitoring 6 session slots at the AMIA 2021 Annual Symposium. I understand that in making the selections for the sessions I will monitor, it is not guaranteed that I will get my top choices. Agree Disagree Question Title * 11. Acknowledge: I have read and understand the requirements stated above. Yes No SUBMIT