To request pins for your ceremony

Please request pins at least ONE MONTH before your scheduled ceremony date.

This form is available to administrators of White Coat Ceremonies at accredited institutions. If your school is undergoing the accreditation process and has not yet received full accreditation, or you are a student requesting a replacement pin, or have any questions about the program, please contact Michelle Sloane, Grants/Programs Manager, at

By requesting Keeping Healthcare Human pins from the Arnold P. Gold Foundation you agree to recognize the Foundation’s gift in published materials with the statement: “Keeping Healthcare Human pins provided as a gift from the Arnold P. Gold Foundation, initiators of the first White Coat Ceremony in 1993.”

Pin Request Form