About YouName(Required) First Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) School Name(Required)Class(Required) 2027 2028 2029 2030 Gender(Required) Female Male Non-binary Prefer not to say Other Other GenderInterestsSpecialties you’re considering (check all that apply)(Required) Emergency Medicine Family Medicine Internal Medicine Internal Medicine/Pediatrics Obstetrics/Gynecology Pediatrics Still Exploring Which practice Locations are you considering? (check all that apply)(Required) Rural Suburban Urban No preference LogisticsDietary Restrictions (vegetarian, gluten-free, allergies, etc.)I’d like to apply for lodging assistance (only available for students outside of Little Rock) Yes No Which nights do you need lodging?(Required) Friday, September 18, 2026 Saturday, September 19, 2026 Would you like to share a room with a classmate? Yes No If you would like to share a room with a classmate, please list their name.Send me updates about visiting student rotations Yes No Opt in to be contacted by participating programs after the event(Required) Yes No What would make this day most valuable? (check all that apply) Meeting specific residency programs Hands-on skills labs Talking to current residents Learning about visiting rotations Interview & match strategy Financial planning & loan repayment Learning what Arkansas is actually like Select All
