DRFMC Student application

Downstate Regional Family Medicine Conference – May 16, 2020 - student application

Students can receive a discounted rate ($15) to attend the DRFMC by completing the information below.

All applications must be received by March 13.

Selected students will be contacted April 1st and will receive a registration discount code, that will set your registration to $15 (regular registration is $90).

Please complete the information below by March 13.

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* 1. Name

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* 2. email

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* 3. School & year

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* 4. I am an AAFP / NYSAFP member

yes

if not, click below to become an AAFP member & consequently an NYSAFP member before submitting application
https://www.aafp.org/membership/join/student.html

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* 5. What fields of medicine are you interested in / are pursuing?

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* 6. Please provide a short paragraph of why you are interested in attending the Downstate Regional Family Medicine Conference.

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* 7. Please briefly describe [300 words] any of your community activities relevant to family medicine and/or your interest in patient-centered family health care

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* 8. Any additional comments (background education, reason you are in the field of medicine, etc.):