Personal Information Form
(Used only by the Pre-Medical Committee)
Please attach a
recent picture of
yourself here:
Name:
Graduation Date:
Concentration:
AAMC ID #
School Address, Phone, email:
Permanent Address, Phone, email
____________________________
_________________________________
____________________________
_________________________________
____________________________
_________________________________
____________________________
_________________________________
Summer Address, Phone, email:
____________________________
____________________________
____________________________
____________________________
State of Legal Residence: ______________________________
Academic Record
1. GPA. Please compute your Grade Point Average (GPA) according to AMCAS
specification:
CHART TO CALCULATE HARVARD 15 SCALE TO 4.0 SCALE
4.0 Scale
A to F
Harvard Scale
Harvard Rank
4.00
3.70
3.30
3.00
2.70
2.30
2.00
1.70
1.30
1.00
0.70
0.00
Freshman Year
Sophomore Year
Junior Year
Senior Year
Concentration:
A
AB+
B
BC+
C
CD+
D
DE or F
15
14
12
11
10
8
7
6
4
3
2
0
Science:
Science:
Science:
Science:
I
I
II
III
III
IV
V
V
VI
VI
VI
VI
Non Science:
Non Science:
Non Science:
Non Science:
Overall GPA
Science:
Non Science:
*Please attach your most recent unofficial transcript.
Overall:
2. List any academic honors, prizes and fellowships that you received while at
Harvard.
3. MCATs
When do you plan on taking the MCAT?
If you have already taken the MCAT, what were your scores?
Phys Science ________ Bio Science _________ Verbal ________ Writing _________
Total Score __________
* Your MCAT scores are not automatically sent to the house. As soon as you receive
your scores, make a copy of them and send to the Senior Tutor’s Office.
Curriculum Vitae (CV)
Probably better known to you as the resume, your CV plays an important role in
showcasing your educational background, work experience, activities, and skills. Your
CV will change over the years as your credentials change, but for now it will probably
not be much different from your classmates who are seeking employment.
General guidelines:
Chronological or backwards chronological order, depending on whom you talk to.
Sections:
Contact information (school and permanent), including email.
Education (name, state, and city of each school, dates of attenance or date
of graduation, degree and concentration. You may want to describe areas
of special interest or training. For now, it’s still okay to list high school.)
Work/research experience Describe your involvement & responsibilities.
Extracurricular activities List those that represent a significant
Involvement (e.g. leadership role)/
Publications (if any)
Personal interests (one line; can include special talents e.g. language
Fluency).
One page (perhaps two for really, really, really good reasons. Focus your CV on
activities relevant to a career in medicine, but don’t omit activities that you’ve been
deeply involved in.
Keep the font size readable (probably so smaller that 11 point). Avoid fancy fonts or
flourishes; they’re distracting.
You should have several people (friends, family your resident tutors, you advisor etc.)
look at your CV for style, substance, and typos.
Personal Statement
This is probably the most difficult part of your application. How do you define yourself, your motivations, your
aspirations, etc. in a 1-page essay?
What they want to hear about is, literally, why you want to be a doctor –i.e., your motivation for going into
medicine. You can approach this question in several different ways (these are not exclusive).
1) Write about a significant experience you’ve had with the medical profession (e.g. when you or a family
member was a patient, when you volunteered in a hospital or health-relate activity, when you
shadowed a physician, etc.)
2) Describe a series of experiences (e.g. through volunteering or extracurricular activities, life events) that
added to your conviction that medicine is the right field for you. (see below for hints).
3) Describe the personal qualities & strengths that would make you a good physician (and give specific
examples).
Some Suggestions:
1) Write about things that are important to you. If you’re bored while writing them, others will be bored while
reading them.
2) When describing a series of events, people often use chronological order. This isn’t incorrect, but a stronger
essay will result if you write by themes and use examples for each theme. E.g. instead of “I first began to be
interested in medicine in my sophomore year of high school when… In my Junior year, I began to volunteer at
the local hospital…In my senior year, my sister was diagnosed with leukemia…” Try “Through my
experiences with medicine, I have come to realize how difficult and rewarding a medical career can be…As a
patient, I viewed my pediatrician as all-knowing and brilliant… As the brother of a young girl with leukemia, I
found out to my frustration and anger, just how much the doctors didn’t know….As a volunteer, I realized that
patients and families needed reassurance and…” There’s no law that you can mention an experience only once
in an essay, if there are multiple aspects that apply to different themes.
3) If you write about your research, show how it might be applied to clinical medicine. (But don’t stress out too
much if you can’t apply it; not all scientific research is research is relevant to medicine.)
4) Be specific! Give examples!
5) Write good, clear English.
6) Again, have critical people read your personal statement with an eye for clarity, conviction, and grammar.
After reading your personal statement, a person should have a clear sense of who you are & what you might be
like in person.
7) Have the people who read your statement identify what aspects of you personality or experiences are not
addressed in your essay. You should try to write other short essays that cover those gaps, or be ready to bring
them up in your interviews.
8) Finally, a word about “packaging”. Successful applications give a strong sense of the actual person. Good
packaging links together seemingly different aspects of your life, personality, interests, etc. to build a consistent
picture of you. To package yourself well, everything you say or write (or is written about you, ideally) should
bring up the same few themes over and over again. This doesn’t mean you present yourself as one-sided—just
consistent. If this concept is confusing you, discuss it with one of the resident tutors.
Personal Statement
(This can be used as a basis for your AMCAS and/or Medical School application essay)
*Please add as many pages as you need.
II.
Before College
1. High School and location (city and state)
_______________________________________
_______________________________________
_______________________________________
2. List all your high school activities and achievements. Give us specific examples of
what you accomplished in each of these activities and how that would be relevant to an
Admission Committee’s evaluation of you.
III. Freshman Year
1. List all of your freshman science courses, your grades in those courses, and any
unusual circumstances that may have affected your performance.
2. Discuss participation in community service, athletics and extracurricular activities.
In what ways were these experiences meaningful to you? How much time did they
involve? What positions of leadership did you hold? Tell us about any part-time jobs
you held during the academic year.
3. Describe your summer activities (employment, vacation, etc.). If describing research,
give us as much detail as possible about your project, the extent of supervision you had,
abstracts or papers published and any special experiences.
IV. Sophomore Year
3. List all of your freshman science courses, your grades in those courses, and any
unusual circumstances that may have affected your performance.
4. Discuss participation in community service, athletics and extracurricular activities.
In what ways were these experiences meaningful to you? How much time did they
involve? What positions of leadership did you hold? Tell us about any part-time jobs
you held during the academic year.
3. Describe your summer activities (employment, vacation, etc.). If describing research,
give us as much detail as possible about your project, the extent of supervision you had,
abstracts or papers published and any special experiences.
V. Junior Year
5. List all of your freshman science courses, your grades in those courses, and any
unusual circumstances that may have affected your performance.
6. Discuss participation in community service, athletics and extracurricular activities.
In what ways were these experiences meaningful to you? How much time did they
involve? What positions of leadership did you hold? Tell us about any part-time jobs
you held during the academic year.
7. Describe your summer activities (employment, vacation, etc.). If describing research,
give us as much detail as possible about your project, the extent of supervision you
had, abstracts or papers published and any special experiences.
8. If you intend to write a thesis:
a. Please describe your project. Attach any publications or research summaries. List
any scientific conferences that you have attended.
b. Discuss the development of your interest in this area. Will you pursue this area at any
level in the future? What did you gain personally from your experience?
VI. Senior Year
1. List all the senior science courses that you plan on taking (or have taken).
2. Discuss your intended participation in community service, athletics and extracurricular activities.
3. What are your summer plans?
4. If you are applying to medical school as a senior, what are your plans for the year
after graduation prior to Medical School?
VII. Letters of Recommendation
1. Waiver forms are available outside the Senior Tutor’s Office.
2. If you are not sure of a particular recommender’s letter, indicate that you “do not
waive the right”. (So that you may read it.)
3. All letters of recommendation should be in the Senior Tutor Office by June
11, 2003, at the latest. You may check which letters have arrived by calling Pat
Keohane, 495-8101 between the hours of 9:00 am and 5:00 pm, Mon.-Fri.
4. List the names of all the people from whom you have requested letters of
Recommendation. Indicate next to their names, which letters you wich to have
Sent with your applications to medical schools (we recommend no less that three
And no more than five). The same recommendations will go to all the schools
you apply to. Please provide phone numbers of your recommenders.
Letter of Recommendation Waiver Form
STUDENTS: please complete this form and give it to your recommender along with a stamped
envelope addressed to Dr. Cole Crittenden, Allston Burr Senior Tutor's Office, 64 Linnaean
Street, Cambridge, MA 02138
Name of Student (please print)
Class Year
_______
Name of Recommender (please print)
_____or  Dean’s Letter
Purpose of Recommendation _______________________________________________
Date Recommendation due at __________________House ________________________
Section A: Consent
In conjunction with the Family Rights and Privacy Act of 1974 I, the above named student, do
hereby give Harvard University and Currier House permission to release this letter of
recommendation to any person or place designated by me, or for use in forming composite letters,
such as Dean's Letters. This consent is to remain in effect until revoked by me in writing.
Student Signature_____________________________Date_______________________
Section B: Waiver
I, the above named student, _____ waive / _____ do not waive any right of access I
might have, as provided by law, to this letter of recommendation.
Student’s Signature ____________________________Date _______________________
Section C: Recommender’s Acknowledgement
RECOMMENDERS: please sign this form to indicate your awareness of the student’s choice
regarding right of access to your letter of recommendation. Enclose this signed form with your
letter and send in the envelope provided by this student to Dr. Cole Crittenden, Senior Tutor’s
Office, Currier House.
Recommender’s Signature _______________________ Date ______________________
Sometimes letters are quoted in forming composite Dean's letters, when the full letter is not submitted. If you do not want your letter
excerpted in this way, check here.
ACADEMIC FILE RELEASE FORM
Student Name (please print):
________________________________________________________________________
I, the above named student, do hereby grant permission to:
(print name of person or committee accessing your file)
to access my educational records for the purpose of advising me and or preparing a letter
or composite letter of recommendation on my behalf to be mailed to persons or places as
designated by me.
Signature:
________________________________________________________________________
Date:
________________________________________________________________________