University of South Florida Morsani College of Medicine Office of Graduate and Postdoctoral Affairs Secondary Application Please complete this application by TYPING in your information. Use the TAB key to navigate. ADMISSIONS APPLICATION INFORMATION Term of Entry Fall Summer Spring Year (IMS only) Instructions: Select one program by placing an “1” next to the program OR select up to three programs, by marking “1”, “2”, and “3” in the order of preference in which you would like your application reviewed. MSMS (one year master’s pre-professional program) MSMS, Health Sciences concentration (100% online) MSMS, Aging & Neuroscience concentration MSMS, Molecular Medicine concentration MSMS, Women’s Health concentration MSMS, Anatomy concentration MS, Biotechnology MS, Bioinformatics & Computational Biology MSMS, Interdiciplinary Medical Sciences *Must apply through AMCAS first & then be selected by the program FUTURE PLANS Medical School Dental School Veterinarian School Optometry School Pharmacy School PhD Program Other Undecided HOW DID YOU HEAR ABOUT US? AAMC website Studentdoctor.net Graduate School Fair Internet search Undergraduate advisor Friends and family Current student/alumni Other: STUDENT IDENTIFICATION INFORMATION Legal Name: (Last Name) USF Student ID: (First Name) U- (Middle Name) Date of Birth: U GENERAL PERSON INFORMATION Sex: MALE FEMALE Ethnicity: 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 City / State / Zip Code Telephone Number (please include area code) Apartment Number Country PERMANENT E-mail Address (for preferred means of communication) TRANSCRIPTS / PRIOR COLLEGE INFORMATION Undergraduate Institution—City, State or Country GPA Major / Graduation Date (or anticipated) Graduate Institution—City, State or Country GPA Major/ Graduation Date (or anticipated) 6/30/16 UNOFFICIAL TEST SCORES WARNING: This section MUST be completed. GRE (General Exam) MCAT Verbal: Biological Sciences Quantitative: Physical Sciences MCAT (old) Verbal: AAMC ID to verify MCAT scores: Other Test (e.g., PCAT, VCAT, DAT, etc): Social Sciences Biological: Critical Analysis Total Score Physical: Verification Code on score report: Score: If you do not have test scores, please fill out the below information: Pending Test-Specify Test ( i.e. MCAT, GRE, DAT, etc): __________ Anticipated Test Date:______________ Note: If you have not taken any test at the time of applying, we will accept your application with pending test scores, but we must have official = test scores in order to make an admission decision. Immediately send your scores directly to our office to expedite the admission process! STUDENT CODE 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 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 pro cess 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 Morsani College of Medicine) with any questions you may have. UNOFFICIAL TEST SCORES APPLICANT RESPONSBILITIES - Applicants are responsible for ensuring their application is complete. Application packages that are mailed incomplete risk delaying the admission process. An e-mail will be sent from the department when your application is complete. If you do not get an e-mail two-three weeks after you mailed the application, please follow-up. - Applicants are responsible for meeting priority deadlines. Application materials sent after the deadline risk delaying the review process. The review process is rolling based on the competitiveness of the applicant pool throughout the cycle and will roll until the class is full. - Applicants are responsible for notifying the department when they wish to withdraw their application from the applicant pool, both prior to or after a decision is made. It is unfair to other applicants to hold a seat or be considered for admission if the applicant no longer plans to attend the institution. The committee reserves the right to rescind offers of admission if the applicant does not respond in a timely manner to the offer. - Applicants should not contact or meet with members of the committee in regards to their application in an effort to persuade a committee member's decision. This is to ensure objectivity and fairness in the admissions process. - Applicants should not request admission decisions over the phone or in person. Staff members will only inform you if your application is complete or incomplete. Applicants will be notified in writing when a decision has been rendered. - Application materials are surrendered at the time of submission per university policy. Documents, including transcripts, test scores, resumes, personal statements, or letters of recommendation, etc. will not be returned to the applicant. 6/30/16