MD Spring Scholarship/Award Recipient Profile

Please complete this form if you received a spring scholarship or award. If you have any questions, please contact Maureen Brady.

* indicates mandatory field
Name*
First Last
Hometown*

City, State (and Country if not U.S.)
Preferred Email Address*
Please check this box if you agree to sharing your email address with the donor in case the donor would like to reply to your correspondence.
- Yes
What is your Class Year?*
Name of Scholarship/Award:*
Have you received additional Spring scholarship/awards you would like to use this profile for?*
- Yes
- No
Please list additional Spring scholarships received*
Year of Award:*
Please take this opportunity to write a thank you note directly to your donor. In your note please share what this scholarship/award means to you.*
Why did you choose to attend the University of Wisconsin School of Medicine and Public Health?*
What are your future career plans and professional aspirations including specialty?*
What has inspired you most during your time at UW SMPH?*
If you have a profile photo you would like to share with your donor, you can upload it here.
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.
Can we use your responses and/or photo for promotional purposes?*
- Yes
- No