THE UNIVERSITY OF NEW MEXICO  HEALTH SCIENCES CENTER
SCHOOL OF MEDICINE
Application for Admission into MD/PhD Program
Form for Current Medical Students
Last Name:
First Name:
Middle Name:
I am applying for admission into the MD/PhD program at the UNM-School of Medicine and request that
the Student Services Office provides a copy of my AMCAS application and MD School grades to:
MD/PhD Program Admissions Committee
Attention: Dr. Valenzuela
BREP Program
MSC08 4560
1 University of New Mexico
Albuquerque, NM 87131-0001
I also request that members of the admission committee are allowed to look at my file.
Thank you for your attention.
Sincerely,
_______________________________
(Signature of Student, and Date)
Please bring this form to: Program Administrator, BREP Office, Health Sciences and Services
Building (HSSB), Second Floor, Room 223, Phone: (505) 272-1887
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