Medicine White Coat Ceremony Confirmation Form

Fields denoted by an asterisk (*) are required.

Identification and Contact Information
Number
OMSAS Number
i.e. 80****
Must be 6 digits. Currently Entered: 0 digits.
Western Student Number
Assigned Campus
Preferred First Name
Preferred Email Address

Required for confirmation of submission
Mobile Phone Number Mobile Phone Number - ### - ### ####
Orientation Week

Monday August 26th to Friday August 30th, 2024

Attendance at in-person or virtual Orientation Week sessions is mandatory for all incoming medical students. Absence will only be considered in the event of extenuating personal circumstances, supported by a letter to admissions.medicine@schulich.uwo.ca. Please avoid other commitments during this time period as not all requests will be granted.
I confirm that I will attend Orientation Week sessions, Monday August 26th to Friday August 30th, 2024

I confirm that I will attend Orientation Week sessions, Monday August 26th to Friday August 30th, 2024 I confirm
White Coat Ceremony

Tuesday August 27th, 2024

Attendance at the White Coat Ceremony is mandatory for all incoming medical students. Absence will only be considered in the event of extenuating personal circumstances, supported by a letter to admissions.medicine@schulich.uwo.ca. Please avoid other commitments on this date as not all requests will be granted.
I confirm that I will attend the White Coat Ceremony on Tuesday August 27th, 2024.

I confirm that I will attend the White Coat Ceremony on Tuesday August 27th, 2024. I confirm
Guests

There is NO limit on the number of guests who can attend the MD White Coat Ceremony at Alumni Hall and therefore tickets are not issued for admittance. However, for planning purposes, please indicate the estimated number of guests you will have below.
Estimated number of guests (excluding yourself)
Lab Coat Selection
Coat Size Selection
Please select a coat based on the following “Chest, Waist, Hip” measurements (in inches):

Coat Size Selection
Please select a coat based on the following “Chest, Waist, Hip” measurements (in inches): XS (32, 26, 32) S (34-36, 28-30, 34-36) M (38-40, 32-34, 38-40) L (42-44, 36-38, 42-44) XL (46-48, 40-42, 46-48) 2XL (50-52, 44-46, 50-52) 3XL (54-56, 48-50, 54-56) 4XL (58-60, 52-54, 58-60)
Phonetic Pronunciation of Name

Please indicate below which first and last name you want to appear in the program and spoken during the ceremony. Please provide the phonetic pronunciation of your name below (e.g. Andrea: on-DRAY-ah; Krause rhymes with House)
Name Name First Last
Phonetic Pronunciation First Name
Phonetic Pronunciation Last Name
Name Tag

Please indicate the name you wish to appear on your official Schulich Medicine name tag.
First Name (legal or preferred)
Last (legal only)

Medicine White Coat Ceremony Confirmation Form

Medicine White Coat Ceremony Confirmation Form

Identification and Contact Information

Orientation Week

White Coat Ceremony

Guests

Lab Coat Selection

Phonetic Pronunciation of Name

Name Tag