Family Medicine Interest Group Funding Initiative Application

Family Medicine Foundation of Michigan (MAFP's philanthropic arm that was formerly named MAFP Foundation) invites your Michigan Family Medicine Interest Group (FMIG) to apply for grant funding for the upcoming academic year. The funding is intended to support your FMIG's activities and efforts to increase student interest in Family Medicine in Michigan. To be considered for funding from the Foundation, your FMIG must complete this application no later than April 10.
 
Requests are not guaranteed. The information your FMIG provides on this application will be reviewed by the Family Medicine Foundation of Michigan's Student & Resident Education Committee, which will then provide funding recommendations to the Foundation's Board of Trustees. Upon the Trustees' funding determination, your FMIG will be notified.

Funding Requirements: Should your FMIG be awarded funding, it will be required to:
  1. Provide a minimum of one opportunity for MAFP leadership/staff to attend and address the students during an FMIG event for which Family Medicine Foundation of Michigan funding is being utilized.

  2. Recognize the Family Medicine Foundation of Michigan as a supporting organization of the FMIG through verbal recognition at all events/activities where Foundation funding is being utilized; the FMIG's website (if applicable) with a hyperlink to www.mafp.com; and a printed logo on promotional materials for activities/events where Foundation funding is being utilized.

  3. Complete a final report by April 10 of the current academic year and submit to the Foundation photos, promotional materials, news releases, and other materials showcasing the events your FMIG hosted throughout the year for which Foundation funding was utilized. 
Questions? Please contact MAFP Headquarters at info@mafp.com or 517.347.0098.
 

FMIG INFORMATION

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* 1. FMIG Name:

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* 2. Medical School:

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* 4. FMIG Website:

FMIG PRIMARY FACULTY ADVISOR - PHYSICIAN

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* 6. First & Last Name:

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* 7. Degree/Designation:

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* 8. Title:

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* 9. Email Address:

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* 10. Primary Phone Number (including area code):

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* 11. Number of Years Serving as a Faculty Advisor:

FMIG FACULTY ADVISOR/SUPPORT STAFF - NON-PHYSICIAN

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* 13. First & Last Name:

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* 14. Title:

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* 15. Email Address:

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* 16. Primary Phone Number (including area code):

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* 17. Number of Years Serving as a Faculty Advisor:

FMIG PRIMARY STUDENT LEADER

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* 18. First & Last Name:

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* 19. Title:

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* 20. Email Address:

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* 21. Primary Phone Number (including area code):

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* 22. Medical School Class Year:

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* 24. FMIG Leadership Term:

TELL US MORE ABOUT YOUR FMIG

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* 25. What is the estimated make-up of your FMIG?

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* 27. How many students do you estimate will attend each event, on average?

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* 28. What is the projected cost of the events:

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* 29. Please share additional information about your FMIG's planned events for the upcoming academic year:

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* 30. Please identify three proposed events (including the approximate time of year they will be held) from which MAFP leadership/staff may choose to attend and address students in the upcoming academic year:

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* 31. What other sources of funding do you anticipate the FMIG will receive in the upcoming academic year (check all that apply)?

Once your FMIG has finalized its events for the upcoming academic year, please forward the dates and details to Dana Lawrence, MAFP's Director of Communications, at dlawrence@mafp.com. Throughout the academic year, please email to her a brief summary and photos of each event that is supported by Foundation funding.
Thank you for applying for FMIG funding from Family Medicine Foundation of Michigan.

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