New Student Orientation Event Form
Complete this form with information regarding your orientation event plans. Feel free to contact TMA-Medical Student Section Staff, Karen Kollar, at karen.kollar@texmed.org, with any questions you may have.
University Name
Chapter Recruiter Name
First Name
Last Name
Chapter Recruiter Email
example@example.com
Chapter Recruiter Cell Phone Number
-
Area Code
Phone Number
Address - provide an address that TMA can use when mailing recruitment materials.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Orientation date
Time of the orientation event
Orientation Location
Number incoming first year class
The number of member benefits packets we send to you will be based on this number.
Is TMA participation within your event possible?
Yes
No
Tell us more about the type of event and/or any role TMA could play.
Example: setting up a booth, providing a brief presentation on the benefits of membership, etc.
Will your chapter opt into TMA’s 100% Student Membership Program?
Yes
No
Who will be providing your chapter roster to TMA-MSS staff?
Chapter Officer
School Staff
100% member roster - school staff contact name
First Name
Last Name
Staff contact title
Staff contact email
example@example.com
Staff contact phone number
-
Area Code
Phone Number
100% membership roster - chapter officer contact name
First Name
Last Name
Chapter officer contact email
example@example.com
Chapter officer contact phone number
-
Area Code
Phone Number
Submit
Should be Empty: