Medical Student Service Leadership Award

Thank you for your interest in applying for the Medical Student Service Leadership Award! Please provide the information below for review by the USU chapter prior to national submission. 

Email the following items to

  1. The completed checklist (Download here).
  2. A four-page description of the project with a detailed budget written by the student team leader. Details of the role of the students in project preparation and execution must be provided.
  3. Description of the team and team leaders and leadership components, including ways in which students will have opportunities to develop leadership skills.
  4. Description of AΩA Chapter role in project (if applicable).
  5. Description of the role of the faculty mentor(s)/ advisor(s), and leadership curriculum for the students.
  6. A letter of support from the faculty mentor(s) that indicates the mentor's commitment of time and interest to the project, the students, and leadership development.
  7. Faculty mentor biosketch(es) (three to four pages).

Submit the following personal information:

Name *
Phone Number *
Phone Number
Mailing Address *
Mailing Address