AMWA Internship Certificate Request
Thank you again for taking your time to intern with AMWA. Your hard work has helped AMWA advance initiatives to advocate for women in medicine, promote equity, and improve healthcare. Please fill out this feedback form to request a certificate of completion and provide feedback on your experience. Thank you again for contributing to the work of AMWA, and we hope that you will stay engaged as you move forward in your career.
Name
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First Name
Last Name
E-mail
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Would you like a certificate of completion?
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Yes
No
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
To what extent do you agree with the following statements?
The internship experience enhanced my understanding of advocacy in medicine.
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Strongly disagree
Strongly agree
1 is Strongly disagree, 5 is Strongly agree
The internship experience enhanced my connection with other AMWA members.
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Strongly disagree
Strongly agree
1 is Strongly disagree, 5 is Strongly agree
The internship experience met my expectations.
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Strongly disagree
Strongly agree
1 is Strongly disagree, 5 is Strongly agree
I would recommend this internship to others.
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Strongly disagree
Strongly agree
1 is Strongly disagree, 5 is Strongly agree
Please reflect on your internship experience below.
Please provide any constructive feedback to the internship team.
Agreement and Electronic Signature
I have completed work for the AMWA Summer Internship. I am an AMWA national member.
Signature (Electronic)
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