PrairieMD School/Community Registration Thank you for your interest in the PrairieMD program. This registration form is to collect a baseline set of information for administrative staff in the USask College of Medicine to begin planning a PrairieMD presentation for your school. If you have any questions or concerns regarding the PrairieMD program, please contact the College of Medicine's Recruitment Coordinator, Davis Frerichs, at davis.frerichs@usask.ca Question Title * School/Community Information School Name School Division Community Name Grade/Class Question Title * Teacher/Counsellor Contact Information First Name Last Name Email Cell Number Question Title * Expected number of students attending the PrairieMD presentation Question Title * When is your preferred time frame (date/times) to schedule a PrairieMD school visit. Please enter a range of dates to select from or a re-occurring date/time that would work for your class. Preferred Time Frame Secondary Time Frame Question Title * Other comments Submit