Galen V. Henderson, MDSEED ProgramA Medical StudentSummer Program

Galen V. Henderson, MD

SEED Program

A Medical Student

Summer Program

Stimulate Equity, Education, and Diversity (SEED)

in Organ Donation and Transplantation

Please review the qualifications and ensure that you meet all requirements before completing the application.

Qualifications:

Last Name*

First Name, MI*

Your Mailing Address*

Your Medical School Email Address*

Your Cell Phone Number*

Phone

Medical School*

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(Other) Medical School

Current Medical School Year*

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U.S. Citizen, Permanent Resident of U.S., or U.S. Noncitizen National*

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Any Personal History with Organ Donation or Transplantation?

Personal History with Donation or Transplantation?*

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(Yes) History with Donation

Please tell us about your history with donation or transplantation.

How did you learn about the SEED program?*

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(Other) Please tell us how you heard about the SEED program.

Please attach the following documents:

Brief Personal Statement (450 word maximum):
Describe your reasons for applying to the Galen V. Henderson SEED Program and how you believe the program will help in your personal and professional development.
Your Resume or CV

File Upload*

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A signed and dated letter of recommendation on institutional letterhead from your medical school Advisor should be addressed to the SEED Program Director and emailed to the address below.
In addition to commenting on your qualifications and character, this letter should also confirm your medical school enrollment and your good standing within the program.
Your application will not be considered complete until this letter is received.