City, State, Zip
Mentor Title & Department
Proposed Date for Student Clinician's Ceremony
Name and Title of Dean to Sign Certificate
How many years has your school been holding an SCC?
Number of Students in Class
Do you recite/discuss an oath?
Is there a joint 2nd/3rd year student working group?
Do you display a poster of award winners?
Do you hold a reception following the SCC?
Do you give a gift to the rising 3rd years?
If so, what?
Describe any additional components of your school's SCC which might be of interest to other schools.