AMAM Scholarship Application 2020

The All Member Advocacy Meeting (AMAM) is your opportunity to get involved with CAFP's advocacy efforts. Family physicians, residents and medical students will head to the State Capitol on March 14-16 to learn about hot-button issues in California health care; hear from experts and legislators; and participate in trainings on advocacy, messaging and leadership.

The CAFP Foundation is pleased to offer 15 scholarships in the amount of $500 each to support medical student and Family Medicine resident participation in the 2020 AMAM. To be considered for these stipends, please complete this form no later than December 20.

Contact Information

CAFP/AAFP ID Number:

First Name:

Last Name:

Phone:

Mailing Address Line 1

Mailing Address Line 2

City

State

Postal Code

Program Information

Please indicate your status:

If other, please specify and indicate your place of study/practice:

Medical School (primary place of enrollment):

If other medical school, please specify:

Family Medicine Residency Program:

If other FMRP, please specify:

AMAM Information

Have you attended the All Member Advocacy Meeting before?

YesNo

If yes, when?

Have you previously applied for a scholarship to AMAM (through CAFP or a county chapter)?

YesNo

If yes, what was the outcome?

Please tell us why you want to attend the 2020 AMAM? (Include your goals, learning objectives, and how you plan to take this experience back your colleagues/program). Limit your response to 500 words.

Please attach a copy of your CV/Resume.

Please include a professional photo

Contact Information