MEDICAL SCHOOL COMPETITION SERIES - INITIAL SCREENING APPLICATION

  1. Where did you grow up?
  2. Cell phone (if primary)

  3. Details about your hometown and family life.

  4. Name of universities attended, dates conferred, and any advanced degrees or other educational accomplishments.
  5. Please check all that apply.
  6. Don’t be afraid to brag. List as many relevant honors as you can.

  7. If applying on behalf of a minor, answer for the applicant.
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  10. Must read. By checking this box, you agree to the above terms.
  11. Must read. By checking this box, you agree to the above terms.

  12. Use your mouse or finger to sign above
    Type Applicant's Full Name
  13. *FOR VERIFICATION PURPOSES PURSUANT TO 18 U.S.C. 2256 et seq.
  14. TypeParent/Guardian's Full Name:
  15. Please Select


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