Download APPLICATION FOR ADMISSION and more Summaries Medicine in PDF only on Docsity!
I. Personal Data
Last Name (Family Name) First Name Middle Initial MaleFemale
Former Last Name (if any) SSN/SIN (required for US Citz/Perm Res) Date of Birth (month/day/year) Age
Country of Citizenship Country of Birth
US Visa Status (if applicable) US Permanent Resident(Green Card Holder) YesNo Country of Residence Dual Citizenship Yes No Other Country
Mailing Address (Street Address, P.O. Box)Floor etc.) Mailing Address Line 2 (Apartment, Suite, Unit, Building,
City or Town State/Province/County ZIP Code/Postal Code Country
Home Phone Number(Country/Area/City Code) Cell Phone Number(Country/Area/City Code) Email Address
Permanent address if different than mailing address:
Permanent Address (Street Address, P.O. Box)Floor etc.) Permanent Address Line 2 (Apartment, Suite, Unit, Building,
City or Town State/Province/County ZIP Code/Postal Code Country
APPLICATION FOR ADMISSION
Entering Term: August Term 20 January Term 20 April Term 20 School of Medicine Programs: Doctor of Medicine Program Four-, five-, six-, and seven-year programs Grenada St. George’s University of Grenada School of Medicine/Northumbria University (SGU/NU) Four or Five Year MD Program One year of preclinical sciences and/or the first year of basic sciences completed at Northumbria University in the UK. Both Grenada and SGU/NU
Post-Baccalaureate Premedical Program Four-year MD Advanced Standing ApplicantThe Committee on Admission must give prior approval for an application for advanced standingto be submitted. Dual Degree Program MD/MPH MD/MBA in Multi-Sector Health Management MD/MSc
High School Name (if in US) High School City High School State Are your parents/relatives gradautes of St. George’s University? Yes No If yes, please list first name, last name, and relationship:
Mother’s Occupation Father’s Occupation
II. a. How did you learn about St. George’s University? (Please be specific)
School Advisor Name: Advertisement: Newspaper/Magazine Internet Banner Word of Mouth Name: SGU Affiliate SGU Graduate SGU Student SGU Faculty Visiting Professor Health Professional (MD, DVM, ETC.) Other Email from SGU Internet Search Social Network: Facebook Twitter Other: Campus poster College Fair/Professional Conference Reference Book Other:
b. What factor(s) influenced your decision to apply to St. George’s University? (Please be specific)
Residency Placements upon graduation Clinical training network USMLE pass rates Large number of SGU grads in the workforce Student services Campus Dual degree opportunities International experience Other:
c. Were you contacted by phone or email after requesting information about St.
George’s University?
Yes No If yes, please check one: Student Graduate Admission Counselor Did this influence your decision to apply to St. George’s University? Yes No
IV. Employment, Volunteer Work, and Extracurricular Activities
You may submit a summary of work, research, and volunteer experience in a current CV or resume as an alternative tocompleting this section.
- List EMPLOYMENT in the last four years, please provide hours worked per week: Dates: Hours per week: Description:
Dates: Hours per week: Description:
Dates: Hours per week: Description:
- List VOLUNTEER WORK in the last four years, please provide hours worked per week: Dates: Hours per week: Description:
Dates: Hours per week:
Description:
Dates: Hours per week: Description:
- List all EXTRACURRICULAR ACTIVITIES: Dates: Hours per week: Description:
Dates: Hours per week: Description:
Dates: Hours per week: Description:
VI. Essay
Personal Statement: Please provide personal information that is otherwise not included in the application. Maximum 1500 words. (Required of all candidates)
Optional Essay: If you feel that your academic record and/or background is somewhat unusual, please state to the Committee on Admission a concise explanation of your path towards medicine.
Note: YOUR APPLICATION WILL NOT BE REVIEWED UNLESS ALL APPLICABLE SECTIONS ARE COMPLETE. By submitting this form, you agree to be contacted by phone, email, or text about your education at St. George’s University. Before submitting this application, you affirm the following with your initials: I understand that once my application has been submitted it may NOT be altered in any way. I certify that all of the information in the application is my own work, factually true, and honestly presented. I authorizeall schools attended to release all requested records and authorize review of my application. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false. I quality to that upon which the offer was based. understand that an offer of admission is conditional, pending receipt of final transcripts showing work comparable in
A student’s acceptance into the School of Medicine is granted upon the presumption by the Committee on Admission that: (1) allcourses currently being taken by the applicant will be completed prior to registration; (2) all statements made by the applicant during the admission process—whether oral, written, or in submission of academic documentation—are true and correct. If it issubsequently discovered that false or inaccurate information was submitted, the University may nullify a candidate’s acceptance or, if the student is registered, dismiss the student.
Signature of Applicant: Date:
