First Name:

Last Name:

Student ID:

  (ex. 12345678)  

Expected Graduation:

  (ex. spring 2010)  

Please indicate when you took or intend to take:

Health Law:

  (ex. spring 2010)  

Health Care Finance:

  (ex. spring 2010)  

Health Care Fraud and Abuse:

  (ex. spring 2010)  

Food and Drug Law:

  (ex. spring 2010)  

Administrative Law:

  (ex. spring 2010)  

Pharmaceutical and Medical Device Marketing & Compliance:

  (ex. spring 2010)   

Please list any Health Law electives you have taken or are currently taking:

Elective 1:

Elective 2:

Elective 3:

Elective 4:

When and how do you plan to satisfy your Health Law AWR?

If you are interested in future health law or IP law job opportunities, please list your personal email and mobile phone number below:

Personal Email:

Mobile/Cell Phone:

(include area code, no spaces or dashes)