First Aid / USMLE-Rx Student Ambassador Program Application

Use this form to submit an application to become a First Aid/USMLE-Rx Student Ambassador. All fields are required.

Enter your email...*

School Name

Applications without a school name will be discarded.

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Enter your first name...*

Enter your last name...*

What year med student are you?*

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Do you have access to your class listserv?*

Select or enter value

Do you have a personal Facebook account?*

Select or enter value

If yes, please insert your Facebook link.

Do you have an Instagram account?

Select or enter value

If yes, please insert your Instagram link.

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