Family Medicine Interest Group Funding Application

Family Medicine Foundation of Michigan (MAFP's philanthropic arm) invites your Family Medicine Interest Group (FMIG) to apply for grant funding for the 2022-2023 academic year. This funding is intended to support your FMIG's activities aimed at increasing student interest in family medicine.
 
Individual FMIG funding amounts will be determined by the Student & Resident Education Committee and Board of Trustees based on a review of the competitive applications and 2021-2022 final reports (if applicable).
 
To be considered for funding, the application is due by Friday, April 14.
 
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:
  • Use this funding for hosting the FMIG's own events (e.g., food, supplies, promotional materials, speaker costs); FMFM funding may not be used to grant scholarships to students to attend events hosted by other organizations (e.g., to attend FMFM’s Michigan Future of Family Medicine Conference or AAFP’s National Conference of Family Medicine Residents & Medical Students)
  • Notify MAFP / FMFM in advance of all FMIG events for which the FMFM funding is being used
  • Invite an MAFP / FMFM representative to speak during at least one FMIG event during the 2021-2022 academic year about the benefits of MAFP / AAFP membership and how the Academy supports students, family medicine residents, and practicing family physicians
  • Place the FMFM logo on all materials used to promote FMFM-funded events
  • Verbally recognize FMFM’s support at the FMIG’s events for which this funding is being used
  • After each FMFM-funded event, email photos and a brief description of the event to MAFP / FMFM.
  • Submit a final report to FMFM by April 14, 2022, including an itemization of how the FMIG used FMFM funding over the course of the 2021-2022 academic year, the number of students impacted, the cost per event, the cost per student, etc.
  • Contact MAFP / FMFM if it determines that the funds granted to the FMIG will go unused so the remaining funds can be reallocated. 
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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