B/MD Application Form

Pre-Medicine

Pre-Professional Studies
B/MD Program
Biology Department
Chemistry Department
Pre-Med 4 Year Plans

Biology
Biochemistry
Chemistry
Pre-Med FAQs
Pre-Medical Science Certificate

Pre-Professional Studies
Biology Department
Chemistry Department
B/MD Program
Pre-Med FAQs
Pre-Medical Science Certificate
Pre-Med 4 Year Plans
Biology
Biochemistry
Chemistry

Department Contact:
Dr. Zane Mitchell
Dean of Pott College
Email
Office Location:
Education Center 1107
812-464-1977

Department Contact:
Dr. Zane Mitchell
Dean of Pott College
Email
Office Location:
Education Center 1107
812-464-1977

The application for the 2023 B/MD scholarships will close on November 15th 2022.

Personal Information

First Name*

Middle Initial/Name

Last Name*

Address*

City*

State*

Zip*

Date of Birth*

(mm/dd/yyyy)

Phone*

Email*

Academic Information

High School*

Class Rank of High School*

GPA*

ACT Score (?)

SAT Score (?)

AP/IB/Dual Credit Classes Taken & Test Score/Grades

You must complete an application to USI to be considered for an interview. As part of the USI application, your high school transcript and test scores are required.

Activities

List your most significant activities within your school and community, and any employment held.

School Activity Or Organization*

Scholastic Honors*

Community Activity Or Organization*

Employment And Name of Employer*

Essay

Use the space below to discuss your interest in medicine and your long-term goals in the profession of medicine (5000 character limit).

Essay*

References

You will need an evaluation form completed by each of the individuals listed below. Please enter the email for each individual, and an email with the evaluation form link will be sent to them directly.

High School Guidance Counselor Email*

High School Science Teacher Email*

Personal Reference Email*

Family Education Rights and Privacy Act of 1974

The Family Education Rights and Privacy Act of 1974 and its amendments guarantee students access to their educational records. Students may waive their rights of access concerning recommendations. The following signed statement is the applicant's desire regarding these recommendations.

Select One* I waive the right to inspect the contents of these recommendations I do not waive the right to inspect the contents of these recommendations

In lieu of your signature, please type in your initials verifying your selection above.

Initials*

Please Note

You must also complete your USI application to be considered for the scholarship.

8600 University Blvd.
Evansville, IN 47712
812-464-8600

A Carnegie Foundation Engaged University

Pre-Medicine

Department Contact:

Office Location: