PMS Mentee Application Form

Name*

First NameLast Name

Date*

Date

Date of Birth*

Date

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How would you prefer to be contacted?

PhoneEmailOther

Cell Number

Area CodePhone Number

Email Address*

Social Media Profiles/Handles: Minimum of 1

Ex: LinkedIn/bridgetjoy

How did you hear about Pre-Med Solutions?*

Please mark the appropriate selection.*

Are you willing to be mentored based on Pre-Med Solutions philosophy and other best practices for mentoring?*

YesNo

Name of Undergraduate Institution Attended*

BCPM (Biology, Chemistry, Physics and Math) GPA*

All other GPA (Cumulative)

Year of graduation

Name of Graduate Institution Attended

BCPM (Biology, Chemistry, Physics and Math) GPA

All others GPA (Cumulative)

Year of graduation

Have you taken the MCAT?*

YesNo

If yes, how many times?

Score 1:

Score 2:

How did you prepare for the MCAT?

Have you participated in a pre-med summer program?*

YesNo

Have you participated in a post-bac program?*

YesNo

Will this be your first time applying to medical school?*

YesNo

What factors are you using in your selection of medical schools?*

What are your geographical preferences for medical school? *

What is your preferred learning style?*

Visual LearnerAuditory LearnerKinesthetic (Hands On) Learner

Identify any extracurricular activities in which you participated at your undergraduate and/or graduate institution(s). *

If you do not get accepted into medical school this application cycle, what are your plans?*

Identify areas where assistance is needed.*

Identify your strengths.*

Share something unique about yourself.*

Upload Unofficial Undergraduate Transcript(s):*

Browse Files

Upload Unofficial Graduate Transcript(s):

Browse Files

Are you a former S.H.A.D.O.W. Program or Pre-Med Solutions participant?*

YesNo

Are you member of the Divine 9 Greek Letter Organization? (for pairing purposes)

YesNo

Upload Resume:*

Browse Files

Upload Completed AMCAS and/or AACOMAS Application if you have completed it:

Browse Files

Upload Personal Statement:

Browse Files

Upload Professional Headshot*

PHILOSOPHY OF PRE-MED SOLUTIONS

1) We are passionate and intentional about developing the next generation of Black and Brown doctors. Our mentoring and advisement efforts will focus on the underrepresented minority applicant; however, we will mentor anyone that solicits our assistance.

2) We will treat every mentee with dignity, compassion, and respect.

3) We will always be open, honest, and transparent with our mentees by making ourselves available to them mentally, physically, and emotionally. We will offer constructive criticism, and we will be careful not to make comments or suggestions that may destroy the mentee’s dream of becoming a physician.

4) We will demand excellence, persistence, and determination from our mentees, and we will demand the same from our mentors.

5) When appropriate, we will inform the mentee that they should consider pursuing a career other than becoming a physician. This will be done only after a comprehensive review of their application and application history has occurred, and we have had an open and honest conversation with the mentee and with the leadership of Pre-Med Solutions. We will continue to advise the mentee and facilitate them to become successful in whatever endeavor they choose.

Disclaimer:

By placing your initials below, you are acknowledging that an initial consultation will be conducted to determine if consulting/advising services will meet your needs. Furthermore, you acknowledge that you understand that services rendered and/or offered by Pre-Med Solutions do not guarantee admission to a medical school, residency program, graduate program and/or employment.

Be advised that members of the Pre-Med Solutions Team are independent consultants. Therefore, their professional and employment affiliations do not infer an advantage, bias and/or influence on medical school admissions, residency admissions and/or or employment decisions.

Please initial here. *