The 2nd Annual CUMC Virtual Information Session Question Title * 1. Contact Information First Name Last Name Email Address State of Permanent Residence (Please abbreviate, i.e. AZ, NY, etc.) College/University Question Title * 2. Current status First Year Student Sophomore Junior Senior Postbacc Student Recent Graduate Advisor College/University Professor College/University Administrator Other (please specify) Question Title * 3. Which program are you interested in? Select all that apply. Summer Medical & Dental Education Program Summer Public Health Scholars Program NERA MedPrep Program Question Title * 4. Do you plan on attending the virtual fair on November 20th, starting at 5 PM?** Yes No, but please send me additional information via email. Question Title * 5. How did you find out about the CUMC virtual information session? Facebook Listserv Email from friend Email from university employee (professor, academic advisor, etc.) Other (please specify) **Please note that only the first 500 registrants will be able to join the Virtual Information Session due to technological limitations. All additional registrants will be sent the link to a recording of the session with additional program information. Done