ACP Internal Medicine Interest Group Sponsorship Program Application

Joining the ACP IMIG Sponsorship Program is easy. Simply complete and submit the form below. To be eligible for the initial $300 funding and for the incentive program your IMIG must enroll in the ACP IMIG Sponsorship Program by August 1, 2009.

Note: Items marked with * are required.

Step 1. Provide Contact Information


Student Leader

*School Name:

*Name:

*Street Address:

*City, State Zip:

*Email:

*Phone:

 

Faculty Advisor

*Name:

*Degree:

*Street Address:

*City, State Zip:

*Email:

*Phone:

 

Step 2. Provide Fulfillment Information

Mailing Information:

* Materials and Checks should be mailed to: (check one)

Student Leader

Faculty Advisor

*Payee for Checks:

*Please confirm this with your school's accounting office before submitting
(Please note that checks must be made
payable to a club bank account or an
institution, they cannot be made payable to a person.)

 

Step 3. Provide Information about the ACP-Sponsored IMIG Activity


* Brief description of the activity:

 

* Goal(s) for this activity:

 

* Success measures for this activity:

 

Step 4. Prepare and Submit IMIG Bylaws

*It is only necessary to submit a copy of your bylaws if you are a new participant to the IMIG Sponsorship Program, or if you've changed bylaws.

If you have never participated in this sponsorship program before, please e-mail a completed copy of the group’s bylaws to mbrdev@acponline.org. For a sample of interest group bylaws, please see the “ACP Internal Medicine Interest Group Resource Guide”.

Step 5. Submit Your Completed Application and Materials by August 1, 2009

 

Students: Join ACP for Free

Benefits of Membership for Students: ACP's free Medical Student Membership includes benefits designed especially to meet students' needs.

Join Now: Sign-up today and begin enjoying the benefits of ACP Medical Student Membership.

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