2022 MEDacademy Phase One Application
Please complete this application for consideration for MEDacademy. This application is only for phase one (i.e. those who have not previously participated in the program). Official school transcripts must be emailed from an official school employee (their work email address) and should be sent to MEDAcademy@rowan.edu. Official school transcripts can also be mailed to: MEDacademy Summer 2022, Cooper Medical School of Rowan University, 401 South Broadway, Camden, NJ 08103. PLEASE DO NOT SUBMIT MULTIPLE APPLICATIONS -- this will result in a delay of processing your application.

IMPORTANT - After submitting this form please complete the following additional requirements:

1. Visit this link in order to pay your application fee - https://shop.rowan.edu/store/events/listings/55827

2. Share this link with your 2 recommenders -
https://forms.gle/cvWBCWfbLZJmQaB3A

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Email *
First Name *
Middle Initial
Last Name *
High School *
Cell Phone *
Home Phone *
Preferred Email Address -- Please provide the email of the APPLICANT -- this email will be used for program purposes *
Have you participated in JUMP? If so, please specify the year of participation. *
Do any relatives work at Cooper University Health Care? If so, please list name and title. *
How did you hear about MEDacademy -- please be as specific as possible. *
Date of Birth *
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Which of the following most accurately describes you? Select all that apply. *
Required
If appropriate, please share more details on above question.
Ethnicity *
Racial Self-Description -- select all that apply. *
Required
Citizenship *
Street Address 1 *
Street Address 2
City *
State *
Zip Code *
Mother's Highest Level of Education *
Father's Highest Level of Education *
Did your mother attend college outside of the US? *
Did your father attend college outside of the US? *
Mother's Occupation -- please note N/A, if not applicable. *
Father's Occupation -- please note N/A, if not applicable. *
Parent/Guardian Full Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
What Grade Are You in? *
Anticipated Graduation Year *
Overall GPA *
Science GPA *
Career Interests -- Check all that apply *
Required
List extracurricular activities, including volunteer experience, leadership roles and hobbies: *
List employment experience *
Persons in Family/household *
Income level *
Recommender Email 1 *
Recommender Email 2 *
Essay Question: Please explain, considering our mission, what you hope to gain from participating in MEDacademy. *
Optional Essay Question: If scholarship funds become available, they will be disbursed based on need. If you would like to be considered, please state why you feel you should be selected as a scholarship recipient. PLEASE NOTE: IF YOU DON'T ANSWER THIS QUESTION,  YOU WILL NOT BE CONSIDERED FOR SCHOLARSHIP OPPORTUNITIES.
I certify that, to the best of my knowledge, all the information provided in this application is true and complete. CMSRU reserves the right to cancel either phase of the MEDacademy program. In the event that the program doesn’t take place, all deposits will be returned. Please type your full name to indicate your understanding and agreement with the above. *
Please indicate date of submission *
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