Host Program Form: Alumni Volunteer Request

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Host Program Form: Alumni Volunteer Request 2017-07-20T10:04:36+00:00

Welcome to the University of Illinois College of Medicine HOST Program alumni volunteer request form. The HOST Program is designed to assist students who are participating in the National Resident Matching Program (NRMP) and seeking residency placement in the coming year. This program aims to facilitate a connection between student requests and alumni volunteers who are able to host students or provide additional guidance for residency interviews in their local area.

HOST Program Process

We are in the process of formally building the HOST Program and are working to find optimal alumni volunteer hosts across the country to fit student requests. Please fill out the below alumni volunteer form. Once we receive your completed form we will store this information in our database. As student HOST requests are submitted we will evaluate compatibility of the information you provide to their HOST location request. If your volunteer information is compatible with a student request we will ask you to confirm your participation as a HOST Program volunteer. Once we have confirmed alumni interest and availability during indicated dates we will connect you directly with the student via email to confirm logistics.

We ask that when you connect with a student that you remember that you are a representative of the University of Illinois College of Medicine and our tradition of excellence and achievement; and that you conduct yourself in a professional and respectful manner while a student visits your city.




EmailPhone

Residence Information





HOST Homestay (provide lodging for a student in your home)HOST Meal (share a networking meal with a student)HOST Resource (provide local information and resources for a student coming to your area via phone or email, or assist a student on a month-long away rotation find affordable housing).


PROFESSIONAL INFORMATION





I have read and agree to the terms and conditions of the waiver of liability, hold harmless and public release agreement for the University of Illinois College of Medicine HOST Program.

Release of liability agreement can be viewed here.