Worksheet for Premeds at Xavier University of Louisiana
Summer Program Experiences
This worksheet is to be completed by freshman premeds and turned in before leaving the Summer Program Experiences meeting in the Fall term. As summer
program speakers reflect on their experiences, complete this worksheet accordingly.
NOTE: If you were unable to attend this meeting and are completing this worksheet on your own, please find information on at least FOUR (4) undergraduate summer
enrichment or research programs and complete the information below. You may find this information by searching the internet AND reviewing emails previously sent to
you by the PM Office regarding summer programs.
Program #1:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #2:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #3:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #4:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Signature_____________________________________________________ Date_______________
Printed Name_____________________________________________________________________
(OVER)
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Program #5:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #6:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #7:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #8:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
2
Program #9:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #10:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #11:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #12:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
(OVER)
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Program #13:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #14:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #15:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
Program #16:
1) Program name? _______________________________________________________________________________________
2) School/Institution where program held?____________________________________________________________________
3) Who can apply? ___Freshman___Sophomore___ Junior___Senior
4) Program length? _______________
5) Stipend? ____Yes____No; If yes, how much?_______________
6) Is housing provided? ____Yes____No
7) Travel expenses covered? ____Yes____No
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