School Name

Primary Contact

Primary Contact Email

Address

Total Number of Club Members

Mandatory Requirements

Representative on 3 of 4 national conference calls
Call #1Call #2Call #3Call #4

ACOEP-RSO Approved Speaker Visit

Date of visit:

Digital or in-person visit:

Speaker’s Name:

Number of club members present:

Social media platform utilized:

Outreach Event

Date of event:

Number of club members participated:

Brief description of event:

Social media platform utilized:

Minimum of 4 club meetings in this Club of the Year cycle

Please list the date of each meeting, topic of meeting, and number of members present.

Additional Points Earned

Directions: Please record the following information for any additional points your club is eligible.

10 POINTS

Fundraising Events (date, brief description of event, number of participants, total $ raised, social media platform utilized)

Facebook Participation – Officer Discretion

15 POINTS

Represented on all 4 conference calls

Additional Labs, Lectures, etc... (date, topic, brief description, number of participants)

20 POINTS

Journal Club – must have met twice during the Club of the Year cycle (date, number of participants)

30 POINTS

Additional Board Member Visits (date, digital or in-person visit, speaker's name, number of participants present, topic)

50 POINTS

Conference Competition Submissions (Name of club member who submitted, date, description)

75 POINTS

The Fast Track publication (Name of club member who submitted, article title, and date of online publication)

Club support in hosting a Regional Symposium (Name and date of event)

100 POINTS

1 Member present at Scientific Assembly

1 Member present at Scientific Assembly National Membership Meeting

1 Member present at Spring Seminar

If there are events not listed below that you feel are worthy of points please include them with a brief description.

Adequate documentation for additional labs, lectures, etc. and rosters must be submitted here.