Activities and Organizations:
In this portion of the application, please describe up to three of your most recent (within the last year)
or relevant activities in each of the following categories. In the description areas, please provide a brief
description of the activity and its relevance to your development and aspirations. Please note this may
include, but is not limited to, activities or experiences at OSU, within the community, or at your high
school. It also may include such things as participation in sports, charities, clubs, etc.
1. Do you have Activities you wish to describe? * (Yes or no)
2. Activities or Organizations in which you have participated (Enter N/A if not applicable):
Activities & Organizations 1
Activity or Organization _________________________________
Activity Date ____________
Leadership Role within Activity:
Length of Participation__________
Description of Activity:
Work or Volunteer Experience:
In this portion of the application, please describe up to three of your most recent (within the last year)
or relevant activities in each of the following categories. In the description areas, please provide a brief
description of the activity and its relevance to your development and aspirations. Please note this may
include, but is not limited to, activities or experiences at OSU, within the community, or at your high
school. It also may include such things as participation in sports, charities, clubs, etc.
1. Do you have Work or Volunteer Experience you wish to describe? * (Yes or no)
2. Work or Volunteer Experience
Employer ______________________________
Date Employed _____________
Length of Employment _____________
Description of Work:
Awards and Honors:
In this portion of the application, please describe up to 5 of your most recent or relevant awards or
honors in each of the following categories. In the description areas, please provide a brief description of
the award or honor and its relevance to your development and aspirations. Please note this may
include, but is not limited to, awards or honors at OSU, within the community, or at your high school.
1. Do you have Awards and Honors you wish to describe? * (Yes or no)
2. Awards and Honors that you have earned or received:
Awards & Honors 1:
Title of Award _______________________________
Approximate Date ______________
Name of Group Making Award ____________________________
Award Description:
Goals and Statement of Intent:
1. Briefly describe your career goals as you presently see them.
2. In 300 words or less, describe how you intend to accomplish your goals, and how your chosen
program of study will facilitate that.
Additional Questions:
1. Please describe all lifetime efforts you have made personally that qualify as community service, any
acts of a positive nature to help others without pay or privilege. As well as describe the positions you
have held which provided opportunities to develop and implement leadership skills to achieve goals
helpful to others. *
2. Have you applied to medical school for the fall of 2016? * (Yes/No/Not Applicable)
3. Are you from or related to persons from China? (Yes/No/NA)
4. Are you pursuing the Education Double Degree at OSU? (Yes/No/Not Applicable)
Optional Heitmeyer Essay:
1. Do you wish to be considered for the Heitmeyer Scholarship which recognizes a love of learning in
students? * (Yes or no)
2. An essay is required for students who want to be considered for the Powis L. & Winifred C. Heitmeyer
Scholarship. Give examples and discuss how you have an outstanding "love of learning". The examples
may extend beyond science. Try to provide documentation of your examples if possible. Limit to 500
words or less.
*On the application that are not included here:
-Personal Information
-Academic Information
-Campus Questions – Demographic
-College of Science – Transfer from OR Community College
-College of Science – State Residency (California state resident question)
-College of Science – Optional Essay (Extenuating circumstances as to why you have not been more
involved in campus and community activities)