2009


Fill out the form below to help us match you with an accommodating site. Please remember to click the submit button when completed.
Note that we will do our best to accommodate all students but given the number of placements, we are not always able to fulfill requests.
 

Your BUID
Name
BU Email Address
Block #


Are you fluent or medically competent in a language other than English?

 Yes  No
If YES, what language?

Would you prefer a site where languages other than English are used primarily?
 Yes  No

Are you an active member of FaMeS?
 Yes  No

Will you have transportation other than public transit for 3rd yr?
 Yes  No

Please choose the best response to describe where you are commuting from to get to BMC for your classes.
 North of Boston  West of Boston  South of Boston  In the City

Do you have strong preferences as far as the type of site you would like to be placed with? If Yes, please provide details in the box below.
 Yes  No

What other information about your FM site placement would you like to tell us? Please be as specific as possible so we can find a good match!

To follow up on this form, contact Samuel Rodrigues at Samuel.Rodrigues@bmc.org.