This is the member application form for MEDLaunch.

MEDLaunch seeks the best and brightest students, and completion of this form is an indication of your interest and motivation. Following reception of your application, it will be reviewed by the MEDLaunch executive team, and you will be notified via your preferred method of contact regarding future MEDLaunch involvement.

Full Name (required)

Your Email (required)

Phone (optional)

Preferred Method of Contact (Check all that apply): *

School *
Undergraduate - FreshmanUndergraduate - SophomoreUndergraduate - JuniorUndergraduate - SeniorGraduate StudentMedical StudentLaw Student

Major (If medical or law student please include undergraduate major) * *

How would you like to be involved in the MEDLaunch program? (Check all that apply) *
Team LeaderTeam Member

What are your interests in the medical field? (Check all that apply) *
AnesthesiologyCardiologyDermatologyEmergency MedicineFamily and Community MedicineInternal MedicineMolecular Biology and ImmunologyNeurology/PsychiatryNeurosurgeryObstetrics /GynecologyOphthalmologyOrthopedicsOtolaryngologyPathologyPediatricsPharmacology/PhysiologyRadiologySurgeryOther

What are your interests in the MEDLaunch process? (Check all that apply) *
ElectricalMechanicalSoftware / ProgrammingMarketingBusiness PlanningLegalOther

What technical skills do you possess?

Do you have any prior experience that would be pertinent and/or beneficial to a MEDLaunch team? *

Upload Your Resume