Administrative Fellowship Program Application | 2025 Cycle

Please carefully read and respond to the fields below. Note that some questions are mandatory for application submission. Responses cannot be saved if the window is closed before submission.

For more detail regarding the application questions or the required supplemental materials, please refer to our programs application instructions page.

For application-specific inquiries, please email us at: AdminFellow@med.usc.edu

Personal Information

Legal First Name

Middle Name

Last or Family Name

Suffix (Jr., Sr., etc.)

Preferred Name

Please let us know if you have a preferred name if it is different from the information above.

Do you have a former or alternate name?

Please select Yes if you are sending any documentation where your name is listed differently than it appears on your application.

Yes

Date of Birth

Enter your date of birth in MM/DD/YYYY format.

mm/dd/yyyy

Contact Information

Current Address

Street Address

Number Apartment, Suite, etc.

City

State

Country

ZIP/Postal Code

If you do not have a postal code, please enter 00000

Permanent Address

My permanent address is the same as my current address

Yes

Phone and Email

Preferred Email

Phone Number

Phone

Secondary Phone Number

Phone

Education History

Please complete this section by listing all colleges and/or universities you have attended, starting with the institution you are currently attending. if you received multiple degrees from an institution, please indicate the degrees in the "degree name(s)" field the institution's respective section.

Please note that you can type directly into the "College or University" fields. Please type out the name of the institution in the way you would like represented if you do not see a suitable selection.

Current Program(s)

Current College or University

Current Graduate Degree(s)

Expected Graduation Month

Expected Graduation Year

Current GPA

Undergraduate Program(s)

Undergraduate College or University

Undergraduate Degree name(s)

Graduation Month

Graduation Year

GPA

Additional Institution?

Please select "Yes" if you have an additional institution you would like to add.

Yes

Supporting Documents

Please combine your supporting documents into a single PDF with the documents in the below order:

Resume
Statement of Intent (2 page maximum)
Official Graduate Program Transcripts
Official transcripts for all other colleges and universities, in order of latest to first
Letters of recommendation (See application page for details)

PDF Document Naming Convention

Please name the supporting documents pdf with the following naming convention: “Lastname_Firstname.pdf”

Upload your supporting document PDF here:

Drop your files here

Do you have the legal right to work in the United States for Keck Medicine of USC?

Yes

Will you now or in the future require Keck Medicine of USC to commence (“sponsor”) an immigration case in order to employ you (for example, H-1B or other employment-based immigration case)? This is sometimes called “sponsorship” for an employment-based visa status.

Yes

Please certify that the information in this application is complete and accurate by typing your full name in the field below.

Date:

mm/dd/yyyy

Send me a copy of my responses

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