Skip to content
RIAFP Foundation Scholarship Application
Thank you for your interest in receiving a scholarship through the RIAFP! Please fill out the information below to be considered.
*
1.
AAFP Member ID
(Required.)
*
2.
Please enter your contact information:
(Required.)
Name
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Country
Email Address
Phone Number
*
3.
Year of Medical School:
(Required.)
MS1
MS2
MS3
MS4
N/A
*
4.
Year of Residency:
(Required.)
PGY1
PGY2
PGY3
Other
N/A
*
5.
If applicable, have you applied for other scholarships from RIAFP? If yes, please describe.
(Required.)
*
6.
Please tell us why you are applying for a scholarship from RIAFP?
(Required.)
7.
Do you identify as underrepresented in medicine (URiM)? URiM refers to any identities that are traditionally and historically underrepresented in the field of medicine relative to their numbers in the general population?
Yes
No
