Deadline: Nov 1st 2015, to be considered for the 2016 applicant pool
(please print or type)
LOCAL ADDRESS: PERMANENTADDRESS: PHONE NUMBER: EMAIL: MAJOR: EXPECTED GRADUATION DATE: CURRENT GPA: _______ CREDITS EARNED:________ DATE YOU INTEND TO APPLY:_________
Have you taken the standardized exam (e.g. MCAT, GRE, DAT)? Y or N (circle one) If so, list your score_________ If not, List you intended testing date________________
Give the names of three non-committee members (and their associated department) whom you have asked to submit preliminary evaluation forms:
List the schools/programs you intend to apply
Attach a curriculum vitae (CV) or resume which contains the following information:
List your education background. Indicate all schools/programs attended, dates attended, degrees conferred (if applicable)
List all organizations, sports teams, clubs, groups, etc. to which you have belonged in college. Indicate dates, offices held, and extent of participation.
List any jobs (including summer employment) that you have held while a student. Indicate dates and extent of responsibility.
List any awards or honors received.
List volunteer work, internships, or research that you have performed that are related to your health career choice.
Include a well-written essay highlighting why you have chosen a particular health profession as your vocation. Your essay should be within the limits allowed by the central application system or school you intend to apply (e.g. AMCAS = 5300 characters maximum; AACOMAS = 4,500 characters max).
Provide a response to the following questions:
If you are not accepted into the professional school of your choice, what alternative plans do you have?
Share any additional information about yourself that you feel is pertinent.