Application

Contact Information
First Name	Last Name
Medical School Year
E-mail Address	Preferred Phone #

Background Information
Hometown	High School
University/College(s) (separate with commas)	Major(s) (separate with commas)

Mentoring Info/Preferences
I interviewed at these mainland med schools and can provide information on them: (separate with commas)
Mentee request(s) (e.g., male/female, specific name) separated with commas: We will make every attempt to accomodate requests but cannot promise they will be honored.
I intend to participate in all program get-togethers
I intend to keep in touch with my mentee in other ways besides email
I am willing to conduct mock interviews
I am willing to review personal statements for medical school applicants

Please review your information (above) and read the following (below):
YES, I am interested in mentoring a premedical student! As a mentor, I agree to make contact with my mentee at least ONCE A MONTH for the remainder of the academic year. This can be done via phone, email (emails must be returned within 7 days), or face to face. I will also meet my mentee on at least one occasion during this academic year.

Mentee :: Mentor :: Mission :: Events :: Photos :: Links

Questions? Email msmp.jabsom@gmail.com