Pre-Health Scholars Certificate Application

First Name

Last Name

Gender

Female

Male

Non-Binary/Other

Prefer not to Answer

Phone #

Phone

Do you consider yourself a first generation college student?

Yes

What is your student classification?

Undergraduate

Post-Baccalaureate

In what school are you enrolled?

What is your major?

What is your minor?

The University or College that awarded your Bachelors degree?

Other University or College Name

What degree did you earn?

What year did you graduate?

mm/dd/yyyy

Which Pre-Health Scholars Cohort are you applying for?

Cohorts are 2 consecutive semesters and begin in the Fall term only.

Fall 2025

Fall 2026

Fall 2027

Have you applied to a professional health program?

To which professional health program did you apply?

How many times have you applied to professional health programs?

Into which professional health program do you intend to apply?

How did you hear about the Pre-Health Scholars Certificate?

In approximately 100 words, please state why you want to earn this certificate. Please include what you hope to gain from this program.

Please upload your transcript.

Drop your files here