Program Director *

Please provide name with credentials

First Name

Last Name

Program Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

First Name

Last Name

Name

First Name

Last Name

Will any HUCM alumni be in attendance to represent your program? *

Yes

No

*

By submitting this application, I acknowledge and agree on behalf of myself and the residency training program: 1. The Howard University College of Medicine (HUCM) is organizing the 2024 Residency Fair for the convenience of residency programs and HUCM students. 2. The fact that students, residents and/or training programs are permitted to participate in the Residency Fair does not constitute an endorsement of their qualifications and no advertisements or announcements implying such endorsements will be permitted. 3. The Residency Program participating agrees to hold harmless, and shall not seek remedy from the Howard University College of Medicine. 4. The Residency Program understands that the Howard University College of Medicine has disclaimed all liability for damages, costs and expenses, including legal fees that may be incurred because of its participation in the Residency Fair.

I agree

I do NOT agree