2026 Future of Medicine Summer Program
Please complete this form in its entirety by March 1, 2026 to apply for the Future of Medicine Summer Program. Completion of this form does not guarantee acceptance into the program. Students will be notified of acceptance on March 23, 2026 via email provided in this application. For questions, contact Sam Mello-Edwards at SMello@ssvms.org.
Student Name
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First Name
Last Name
Student Email (Please use a PERSONAL email and not a school email)
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example@example.com
Student Cell Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Home zip code
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Date of birth
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
High school attending
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School District
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Grade entering fall 2026
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Junior Year
Senior Year
I am a graduating senior
Have you attended Future of Medicine in the past?
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Yes, in-person summer program
Yes, in-person spring program
Yes, virtual summer program
No
I am applying for
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In-person session I (June 8 - June 26, 2026)
In-person session II (July 6 - July 24, 2026)
I can attend either session I OR session II
I am applying for the virtual only program (Monday - Thursday, June 15-26, 2026)
Transportation aid: Program funding limits how much transportation aid can be approved. To receive transportation aid, applicants must check yes below in this application. Students who are accepted will then be given a Transportation Aid Request Form to fill out. We are unable to approve all requests as funding is extremely limited. Please note: Future of Medicine utilizes rideshare companies like HopSkipDrive to provide transportation. Would you like to apply for transportation aid?
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Yes
No
Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Cell Phone
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Please enter a valid phone number.
Format: (000) 000-0000.
Please upload a short essay, 400-500 words, or a 1 min video describing how this program will help you pursue your career goals. Answer the following questions: What life experiences have led to consider a career in medicine? Do you have family in the medical field? How has this impacted your career aspirations? Are there particular areas of medicine or specialties that interest you? What qualities do you think make a good healthcare provider? How would you offer the best care to your patients? Give an example of a time when you had to think outside the box to solve a problem. How have you effectively worked with a team to achieve an objective? What are your goals for the next five years? If you think medicine is your path, how do you plan to achieve it?
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What specialties are you interested in? (note: we cannot guarantee that you will be placed in this specialty)
Please upload a current high school transcript
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Current GPA
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Please upload a letter of recommendation from one teacher. *If your school requires the letter be sent directly to us, have them email the letter to Sam Mello at SMello@ssvms.org.
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How did you hear about this program?
My school/teacher/counselor
Fellow student/friend
Career fair/public event
Google/online search
Other
Comments
Please review and check off each item on the list below.
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