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. We need at least 3-4 weeks lead time to mail materials and plan for an onsite representative

University Name

Chapter Recruiter/Contact Person

First NameLast Name

Chapter Recruiter/Contact Email

example@example.com

Chapter Recruiter Cell Phone Number

Area CodePhone Number

Address - provide an address that TMA can use when mailing recruitment materials.

Street Address

Street Address Line 2

CityState

Zip Code

Type of Event

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.

Orientation date

Time of the orientation event (Start and End Times)

Orientation Location

Orientation Location Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

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?

Will your chapter opt into TMA’s 100% Student Membership Program?

Who will be providing your chapter roster to TMA-MSS staff?

100% member roster - school staff contact name

First NameLast Name

Staff contact title

Staff contact email

example@example.com

Staff contact phone number

Area CodePhone Number

100% membership roster - chapter officer contact name

First NameLast Name

Chapter officer contact email

example@example.com

Chapter officer contact phone number

Area CodePhone Number