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Registration – Host Volunteer

Please fill out this form if you would like to be a host and the MAA will contact you about student requests for your area.

  • Please provide full names and approximate commuting times from your home ex. University of Virginia Medical Center - 15 minutes; Martha Jefferson Hospital - 20 minutes
  • Please provide full name of hospital
  • City, State
  • Year
  • Hospital or practice name and location
  • If you will be traveling during the months of October through January (Holiday, Clinical, Rotations, etc.), please provide approximate dates of travel and the best way to reach you during these periods: