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Past President's Award Application

The Past President's Award application is now open for 2026 for Medical Students and Residents/Fellows who live/work in Suffolk County.

Sorry, but this form is now closed.

First name*

Last name*

Email*

Phone*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Are you a?*

Medical Student

Resident/Fellow

Personal statement of 500 words or less describing your interest and commitment to public health and your career goals*

PO Box 2274 Huntington, New York 11743

631.851.1400

info@scms-sam.org

© 2026 Suffolk County Medical Society

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