University of South Florida Morsani College of Medicine
Office of Graduate and Postdoctoral Affairs
2016 PhD Secondary Application
Please complete this application by TYPING in your information. Use the TAB key to navigate.
Ph.D. in Medical Sciences (Fall Admission Only)
*We are only currently accepting Fall 2014 applications
STUDENT IDENTIFICATION INFORMATION
Legal Name:
(Last Name)
USF Student ID:
(First Name)
U-
(Middle Name)
SSN Last 4 Digits:
USF
MM/ DD/YYYY( i.e .05/13/1987)
________________
Date of Birth:
UU https://netid.usf.edu/tools/lookup_usfid/public/?width=90%&height=75%&jqmRefresh=false.
GENERAL PERSON INFORMATION
Gender
MALE
FEMALE
Ethnicity (indicate one):
Asian
Pacific Islander
Are you a US permanent resident?
Yes
No
Nation of Citizenship:
Black/Non-Hispanic
White/Non Hispanic
American Indian/Alaskan
Hispanic (all races)
Other
PERMANENT Mailing Address
Street Address
Apartment Number
City / State / Zip Code
Country
DO NOT USE “EDU” ACCOUNTS
Telephone Number (please include area code)
PERMANENT E-mail Address (yahoo, gmail, msn, etc.—Do not use school accounts.)
TRANSCRIPTS / PRIOR COLLEGE INFORMATION
Undergraduate Institution—City, State or Country
GPA
Major
Graduate Institution —City, State or Country
GPA
Major
(If Applicable)
UNOFFICIAL TEST SCORES
Test Information
GRE (General Exam)
Verbal:
Quantitative:
Official GRE (General Test) scores should be sent through ETS to Graduate Admissions (school code: 5828). Please send an unofficial copy of
your test scores from ETS in your secondary application package.
*GRE must be submitted in order for your application to be reviewed
Are you currently, or have you ever been, charged with or subject to disciplinary action for scholastic (such as plagiarism or cheating) or any
other type of behavioral misconduct at any educational institution? You do not need to disclose academic dismissal, suspension or probation for
poor grades. Yes ____
No______
Have you ever been charged with a violation of the law, misdemeanor and/or felony (even if adjudication was withheld) which resulted in, or, if
still pending could result in, probation, community service, restitution, a jail sentence or the revocation or suspension of your driver’s license
(you are not required to include traffic violations which only resulted in a fine)? Yes_______ No________
6/30/16
If your answer to any of the following questions is YES, provide a full explanation of the relevant facts to the Office of Graduate Admissions.
You are required to supply this institution with copies of all official court/educational institution documents explaining the final disposition of the
proceedings. Failure to provide this information will delay an admissions decision.
If your records have been “expunged” or “sealed” pursuant to applicable law, you are not required to answer YES to these questions. You must
however, supply a copy of the document stating the record is “expunged” or “sealed” to the Office of Graduate Admissions. If you are in the
process of having your records “expunged” or “sealed”, you must submit all documentation regarding the incident as the case is not yet
“expunged” or “sealed” by the legal system.
If you are unsure whether to answer “yes”, we strongly suggest that you answer YES and fully disclose all incidents. By doing so, you can avoid
any risk of disciplinary action or revocation of your offer of admission. Please contact the Office of Graduate Admissions at (813) 974-8800 (not
the College of Medicine) with any questions you may have.
UNOFFICIAL TEST SCORES
6/30/16