PRINCETON UNIVERSITY HEALTH PROFESSIONS ADVISING
APPLICANT INFORMATION SHEET
2017 Entering Class
Form
Full Name:
Preferred/Nickname:
Class Year:
PU ID#:
Citizenship:
Princeton Email (if
current student):
State
residency:
@princeton.edu
Permanent Email:
Preferred Phone:
Applying to (check all that apply):
Allopathic (MD) Medical School
Veterinary School
Osteopathic (DO) Medical School
Dental School
Combined Degree (specify):
Other (specify):
ACADEMIC RECORD
Please calculate your overall and BCPM (biology, chemistry, physics and math GPA), for each year, and cumulatively.
These GPAs must be computed prior to your pre-application interview. Refer to the Applicant Handbook for instructions.
Cumulative Undergrad GPAs BCPM:
Year-by-Year GPAs
BCPM
Cumulative
Overall:
Concentration:
Freshman Year
Sophomore Year
Junior Year
Senior Year
Postbac, if applicable
Thesis Adviser or Proposed Thesis Adviser:
Thesis Title or Proposed/Intended Topic (please
be succinct):
Standardized Test Date(s) &
Score(s):
Test Study Method?
Certificate (s):
1
From whom should we expect letters of recommendation?
(Remember, you can request as many letters as you wish, but only 4-6 letters are included in your composite letter. Three must be
academic, two science, at least one from an individual who has taught you in a science course at Princeton, to be eligible for a
committee letter. This list may still be tentative).
Name
Email
In what context do you know the recommender?
Activities Participation:
Please tell us, on average, how many hours per week you have spent in non-academic activities, both on and off campus,
during each of your years in college. Non-academic activities can include volunteer work, internships, jobs, campus
organizations, and leadership positions (e.g., 10 hours work + 15 hours research + 3 hours activities = average 28 hours /
week). These hours should reflect the comprehensive list of activities that you will also submit to HPA.
Freshman Year: Fall:
Spring:
Summer:
Sophomore Year: Fall:
Spring:
Summer:
Junior Year: Fall:
Spring:
Summer:
Senior Year: Fall:
Spring:
Summer:
Courses Taken Anywhere Other Than Princeton: List names of schools, dates attended, and courses taken. Drop off
or email a “student copy” of your school transcript(s) to Health Professions Advising.
due seven days prior to your pre-application interview
please submit through Coursesites or print and bring to HPA office