Whitetulip Pre-Health Mentorship Application Form
This programs is for college students or graduates who would like to apply for health related school and seeking mentorship from Whitetulip members and volunteers.
Full Name
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First Name
Last Name
Email
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example@example.com
section to show later
Applicant School
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Applicant Major
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Current Unweighted GPA
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Expected Year of Graduation
Rewards and Achievements
Expected Year of Medical School Application
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Explain briefly what made you decide to study medicine
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Program(s) Applying for, If Known
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Medicine (MD)
Medicine (DO)
Medicine/Graduate Program (MD/PhD, MD/MPH)
Other (please explain)
Explain briefly your expectation from this Mentoring Program and your ideal mentor-mentee relationship
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Please rate yourself in the following areas by checking one box. (Ratings are used to target mentorship and will not be used to evaluate admission to the program.)
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I'm confident about this
I need some help with this
I need a lot of help with this
I'm not sure yet
I know which classes to take for a competitive medical school application.
I have excellent time management skills
I can identify ongoing volunteer activities.
I can demonstrate and document leadership.
I can line up shadowing activities with medical professionals in areas of practice that I find interesting.
I have opportunities to participate in research that interests me.
I know about the MCAT and have a study plan.
I plan to use my vacations for resume-building activities.
I feel comfortable soliciting letters of recommendation.
I have a good idea of what I’m looking for in a med school.
Have you had previous Volunteer Experience? If Yes, How many hours Per Month? In addition, How many hours can you put in for Volunteer Efforts now?
Have you had previous Shadowing Experience? If Yes, How many hours Per Month? In addition, How many hours can you put in for Shadowing Efforts now?
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Specialty area(s) of interest, if known:
Submit
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