ALPHA OMEGA ALPHA
HONOR MEDICAL SOCIETY
Beta of Louisiana Chapter
Fall 2020 APPLICATION
Thank you for your interest in AOA. In order to streamline the application process and to ensure anonymity, please fill out the form below. Please note that all leadership, research, and service activities listed must have been performed during medical school (i.e. not during high school or undergraduate/graduate school). Also, we ask that you submit a narrative on the following page detailing the additional leadership, research, and service activities that you've entered in the text fields below. This narrative should include your specific leadership duties and your personal roles in the research projects and service efforts. We encourage you to apply even if your leadership, research, and non-SLE service activities do apply to any of the selections in the checklists, as your additional activities are given considerable weight.
LEADERSHIP
Check the boxes at left as applicable to your current or past leadership activities while in medical school. Then, select the number of years for which you held each position by clicking on “0” at right. In the text field below, list other leadership positions that you hold or have held that do not appear in the checklist. Do not include any positions for which you have been elected but have not yet taken office (i.e. future positions) or any positions held prior to medical school.
If you check a box for a leadership position, you must also list that position below. Be specific! If you list a leadership position that falls under one of the below categories, the box next to that category must be checked and the number of years listed. If you fail to do so, no credit will be awarded for that leadership position or activity.

Leadership	No. Years Active
1 1 SGA President	0	
1X1 SGA Officer (other)	1	
1 1 Class President	0	
1 1 Class Officer (other)	0	
1 1 Aesculapian President or Curriculum Evaluation Coordinator	0	
1X1 Aesculapian Board Member (other)	2	
1X1 Aesculapian Member	3	
1X1 Interest Group President or Vice-President	1	
-	SGA Secretary (Fall 2017 - Present)
-	Aesculapian Member (Spring 2015 - Present)
-	Aesculapian Survey Coordinator (Spring 2016 - Present)
-	Student-Run Homeless Clinic Director (Fall 2015 - Spring 2016)
-	Camp Tiger Auction Chair (Fall 2014 - Spring 2015)	

RESEARCH
Check the boxes at left as applicable to your research activities while in medical school (including research conducted during a MD/PhD program or research year). Then, select the number of publications in each category by clicking “0” at right. In the text field below, list other research activities in which you are participating or have participated that do not appear in the checklist. Do not include future research plans or research activities conducted or resulting from efforts prior to entering medical school.
If you check a box for a research experience, you must also list that experience below. Be specific! If you list a research experience that falls under one of the below categories, the box next to that category must be checked and the number of projects listed. If you fail to do so, no credit will be awarded for that research project or experience.

ALPHA OMEGA ALPHA
HONOR MEDICAL SOCIETY
Beta of Louisiana Chapter
Research has to have been submitted for publication in order to be counted in your overall score. With rare exception, research that is “in progress” should not be included in this application. Please indicate in the text box below whether the project has been submitted, accepted, or published/presented.
Research		No.
1 1 Peer-reviewed journal article or book chapter - FIRST author		0
1 1 Peer-reviewed journal article or book chapter - not first author		0
1X1Case study, review, abstract, or poster - FIRST author		1
1X1Case study, review, abstract, or poster - not first author		1
1 1 Presented research at national, regional, or state conference		0
1 1 Submission of grant proposal to external funding agency		0
1 1 Active and ongoing involvement in Honors Program research		0
-	XX; Orgeron, Ed. How to #BeatBama. Sports Illustrated. November 2016. Later disproven and retracted)
-	Swinney, Dabo; XX. How to #BeatBama, Take 2. Sports Illustrated. Submitted for publication in January 2018.

non-sle service
In the text field below, list any service endeavors that you have undertaken during your time in medical school. Do not include service for which you received SLE credit, as this service is included elsewhere in the nomination formula. However, please note that AOA only includes SLE credits from the first 2.5 years of medical school. Do not include future plans for service activities. Please also list the approximate number of hours spent volunteering for each activity (e.g. 3 hours/week for 10 weeks).
-	Volunteer at SPCA (Fall 2015 - Spring 2016) for 2 hours every week for 1 year
-	Youth Leader at St. Joseph’s Church (January 2014 - Present) for 3 hours every other Wednesday for 2 years
-	Intramural Soccer Team Captain (Spring 2015, Spring 2016, Spring 2017)	
narrative
Please use the available space below to expound upon any additional leadership, research, or non-SLE service activities that you entered above in order that we may more accurately assess these intangibles.
-	As SGA Secretary (Fall 2017 - Present), I act as a liaison between the SGA and the student body, send out weekly emails, take minutes at monthly SGA meetings, and assist other SGA members with their duties.
-	As a member of the Aesculapian Society (Spring 2015 - Present)… 
-	As Clinic Director of the Student-Run Homeless Clinic (Fall 2015 - Spring 2016)…
-	As Camp Tiger Auction Chair (Fall 2014 - Spring 2015)…
-	As first author of “How to #BeatBama” (Sports Illustrated, November 2016)…
-	As co-author of “How to #BeatBama, Take 2” (Sports Illustrated, submitted for publication in January 2017)…

ALPHA OMEGA ALPHA
HONOR MEDICAL SOCIETY
Beta of Louisiana Chapter
-	As a volunteer at the SPCA (Fall 2015 - Spring 2016)… 
-	As the Intramural Soccer team captain (Spring 2015, Spring 2016, Spring 2017)…