Post Baccalaureate Pre-medical Program Application

A complete application consists of two parts. Please read the application instructions before you apply. Note that you will need a credit card for the $50 application fee at the end of this application.

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Page 1

Start date

Contact Information





For example, if you and a sibling use the same email address, your accounts may become combined and cause registration delays








HIDDEN





Page 2


Even if you live in Vermont, you must complete this section in order to be considered for in-state residency status. In-state residency is based on UVM Residency Policy
Vermont Residency

Vermont Residency Questionnaire

In order to be considered for in-state tuition, you must complete this section. The final decision on residency is made by the residency office. Regardless of your responses below, it is the student's responsibility to understand their final residency determination before they register. The residency office may request additional information before determining residency status. All Applications for In-State Status should be received no later than the last day of the Add/Drop period for the semester for which in-state status is sought. All applications received after the Add/Drop period will be considered for the following semester for which the student is enrolled.

Learn more about UVM residency criteria


Employers
Please list employers for the last two years below
Employer




MM/DD/YYYY


MM/DD/YYYY 

For example:

IBM, Essex Jct VT, 5/2000-5/2005
Green Mountain Coffee Roasters, Waterbury VT, 6/2005-present


2015- Vermont
2014- Vermont
2013- New York



MM/DD/YYYY


Parent/Guardian's Street Address

Parent/Guardian's City

Parent/Guardian's State

Parent/Guardian's Zip



Enter years and months (i.e. 10 years, 2 months)
Other address





For Vermont Residents Only: The information above does not change the residency status established at your last enrollment. For information on filing for in-state status, contact the Residency Office, Registrar's Office, 85 South Prospect St., (802) 656-8515.

Information is also available online under Policies & Procedures on the Registar's webpage.

Page 3

Student Citizenship



ex. F-1; J-1; L-2; H-4

Student Information

Enter with no dashes or hyphens (ex: 000000000)

MM/DD/YYYY



Race/Ethnicity


Page 4

Disciplinary actions

For military service members

Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.

Schools Attended

Complete for all undergraduate, graduate or professional schools attended. 


if school is not listed, enter below




MM/DD/YYYY (Date you began attending)

Date you stopped attending-- enter planned end date if currently attending

Name the file with your name and the school name. Example: Sally_Smith_Univ_of_VT.pdf

Professional Choice


Adv sci track no longer a choice per request from Tom GAdvanced Science Track is for students who need to strengthen their credentials to apply to med school
Preparatory Science Track is for career changers
Professions

Please check the profession(s) you are interested in pursuing.


Upload Resume

Note: Please make sure your name and the current date is clearly stated on the document. Personal Statement Guidelines: In no more than three typed, double-spaced pages, describe your reasons for pursuing a career in healthcare. Include any related experience you have and explain how that experience has informed your career goals.

Compile transcripts for all schools listed above into one document (pdf or zip) and upload here.  If needed, you can save this form and come back later (link at top of page)
Letters of Recommendation
This program requires two letters of recommendation from people who know you well enough to give an informed opinion of your motivation, intellectual ability, capacity for sustained effort, and personal qualifications. We suggest that at least one of the two letters be an academic reference. Please enter the name and email address of two recommenders.  We will send them a link to enter their recommendation.
Recommender 1



e.g. Dr, Professor



e.g. Professor, colleague, boss
Recommender 2



e.g. Dr, Professor



e.g. Professor, colleague, boss
Guaranteed Admission Program


High Schools Attended

Complete for all high schools attended

  • If you have any difficulty entering schools in the drop-down menu, please use the "Additional high schools attended" section below.

  • Please submit unofficial transcripts for all schools listed.



if school is not listed, enter below

Name the file with your name and the school name. Example: Sally_Smith_Burlington_HS.pdf


You may qualify if you or one of your parents is a current UVM employee.
Signature

I certify that the above information is true and correct

Page 5

Credit Card Information


digits only, no hyphens

3 digit code on back of card near signature area


Card Holder Information









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