Medical Education Resources Initiative for Teens Baltimore, Maryland Leadership@MERITBaltimore.org www.MERITBaltimore.org Class of 2018 MERIT Scholar Application Congratulations on your decision to apply to MERIT! By reading this document, you are already taking the steps you need to become a health care professional. You should be proud of your accomplishments and continue working hard to achieve your goals! We are excited to learn more about you in this application so please take your time when responding to the answers. We recommend you work on this application multiple times until you are 100% satisfied with all of your answers. What is MERIT? The Medical Education Resources Initiative for Teens (MERIT) is a non-profit organization that partners with local universities and hospitals to transform Baltimore City high school students into Baltimore’s health care leaders. We provide three levels of support for three years including weekly Saturday sessions, paid summer internships working in hospitals and laboratories, and mentoring. Our Saturday curriculum provides Scholars with professional development opportunities including sessions focused on leadership skills, health inequalities, SAT prep, college admissions, financial aid guidance, and more! Scholar Responsibilities Becoming a MERIT Scholar is a BIG commitment. Scholars must attend Saturday sessions every week during the school year from January 2016 through May 2018, and be willing to complete paid summer internships in 2016 and 2017. We expect Scholars to represent their schools, families, and MERIT well in all their interactions; therefore, unprofessional behaviors are not tolerated. MERIT Scholars also receive homework assignments and are expected to work together as they make Baltimore a healthier city. Eligibility Because MERIT is a three-year program, only current sophomores graduating in 2018 can apply. MERIT Scholars must live within Baltimore City limits and attend a Baltimore City Public School. In addition, MERIT Scholars must meet one or both of the following criteria: Be eligible to receive free or reduced meals at school (during the 2014-2015 school year) Be among the first generation in his/her family to attend college Application Process Phase 1: Online Application (this packet) We suggest that you type your answers in this document, but if you are not able to save your work on a computer, we will accept hand-written responses. When you have finalized your responses (typed or hand-written), please email it to Leadership@meritbaltimore.org with the subject, “Scholar Application 2015” PRIORITY DEADLINE: Friday, October 30th, 2015 at 11:59 p.m. FINAL DEADLINE: Friday, November 13th, 2015 at 11:59 p.m. Phase 2: Medical Leadership Course (a three-week, in-person tryout) SAVE THE DATES! If you are selected to participate in the second phase of the application process, you must attend the MERIT Medical Leadership Course. You will be required to attend three tryout Saturday sessions. All sessions occur on Saturday’s either from 8:30 a.m. to 12:30 p.m. or 1:00 p.m. to 5:00 p.m. You must attend ALL THREE SESSIONS to be considered for a spot in MERIT, so please make arrangements as soon as possible. The required sessions are: **November 21, December 5, and December 12** 2 Section 1 – Demographic and Contact Information Full Name Name of Current High School Current Grade Expected Graduation Year Gender Identity Racial/Ethnic Identity What is the highest level of education your father has completed? What is the highest level of education your mother has completed? Were you eligible to receive free or reduced meals at school last year? Date of Birth Home Address Home Phone Number Cell Phone Number Email Parent/Guardian Name Parent/Guardian Cell Phone Number Parent/Guardian Email How did you hear about MERIT? Section 2 – Extracurricular Activities *Please list the 2 extracurricular activities, projects, awards, or honors that you are most proud of. Tell us about your role and what you have accomplished. Activity Title Description Activity/Award #1: Activity/Award #2: *Please list the 2 most important interests, passions and/or hobbies you have. Tell us how often you practice your hobbies and what you have achieved. Interest, passion or hobby #1: Interest, passion or hobby #2: 3 Section 3 – Academics What is your Weighted: Un-weighted: cumulative GPA? Science Classes: List all your high school SCIENCE classes, including the current ones. List level as Regular, Honors or AP courses. Course Title Level (Regular, Honors, AP, IB) Final/Current Grade Math Classes: List all your high school MATH classes, including the current ones. List them as Regular, Honors or AP courses. Course Title Have you ever received a failing grade in a class? If so, please explain what led to that grade. Please note that a copy of your transcript will be required for the second round of selection. Section 4 – Short Answers MERIT is a program for students interested in becoming health care leaders. This includes students who want to be doctors, nurses, pharmacists, dentists, medical researchers, and other health-related careers. Please describe your career goal and why that goal is important to you. You may include: what you want to do, where you want to work, whom you want to serve. Feel free to share a personal experience you’ve had that led to your decision to become a health care professional. Suggested Word Count: 250 Level (Regular, Honors, AP, IB) Final/Current Grade 4 Becoming a health care leader will require taking difficult science classes throughout your academic career. Describe your interest in science and any specific topics or concepts that you find particularly interesting. Feel free to draw from your experiences in science classes, other science programs, field trips, or your personal life. Suggested Word Count: 200 Becoming a health care provider is not easy. It requires a lot of work! Therefore, future health care leaders must be willing to work hard, even when they face obstacles. Please describe a challenge you’ve faced in life and how you overcame that challenge. This can be related to school, home life, family, extracurricular activities, or anything else. Suggested Word Count: 200 Section 5 – References Please include two references who MERIT staff can reach out to if we need to learn a little bit more about you to evaluate your application. These may include teachers, counselors, school staff, coaches or supervisors from other academic programs. Applicants who make it to the second round will be asked to get a letter of recommendation but that is not necessary at this time. First Name Last Name Relationship Section 6 – Disclosure of Misconduct Have you ever been charged with any crime or received a criminal citation, regardless of the outcome? If yes, please explain. Phone Email Section 7 – Scholar Commitment 5 I have read the background information outlining a MERIT Scholar’s responsibilities, and have discussed this information and the program requirements with my parent/guardian who is in support of my application. I confirm I am eligible to apply to become a MERIT Scholar. I certify that all the information in this application is true and accurate. If I am selected to be a MERIT Scholar, I commit to fulfilling all MERIT requirements as described above through May 2018, including attending Saturday sessions every week, completing paid summer internships, and working with a mentor. Electronically Sign by Date: Typing Your Name Section 8 - Next Steps and Tryout Dates You will receive confirmation of your application submission within one week of submission. By November 18th, you will be notified if you have been selected to attend the Medical Leadership Course. At that time, we will ask applicants to complete a parent/guardian letter of support, obtain a high school transcript, and have one recommendation letter submitted on their behalf. *Please save the THREE TRYOUT DATES in your calendar: November 21, December 5, and December 12. You will be asked to come to either a morning (8:30-12:30) or afternoon (1:00-5:00) session. If you have a conflict with any of those dates already, please explain below. We will do our best to accommodate your needs, but cannot make any guarantees. Thank you for applying to become a MERIT Scholar! We are excited you are committed to making Baltimore a healthier place. Our city needs you to become a health care provider and MERIT will help you achieve your goals! PRIORITY DEADLINE: Friday, October 30th, 2015 at 11:59 p.m. FINAL DEADLINE: Friday, November 13th, 2015 at 11:59 p.m.