Request edit access
PPHS Committee Interview application 2018
Pre-medical (allopathic (MD), osteopathic (DO)), pre-veterinarian and pre-dental PPHS committee interviews will be held during spring quarter. Applicants must complete this application form and submit all required materials by January 15, 2019. Please report only activities that have occurred since your initial enrollment in college.

An incomplete application will delay you moving forward. Please complete all fields to the best of your knowledge.

Following the completion of this form please email Helen Talbot (Eaton Hall Admin) at talboth@spu.edu to meet to discuss the committee process and your questions and to deliver the signed committee letter waiver. This meeting must take place and waiver be turned in by January 31, 2019, to proceed with the committee process. Please include your name and “Committee Application Follow-up” in the subject head line.

First Name *
Your answer
Last Name *
Your answer
Student I.D. *
Your answer
Email address (best for communicating with you throughout the committee process) *
Your answer
Phone number *
Your answer
Major *
Your answer
GPA (3.0 minimum) *
Your answer
Anticipated or past graduation date
Your answer
Shadowing/unpaid observation hours. *
We recommend Allopathic and Osteopathic acquire 40 primary care hours minimum.
Your answer
Community volunteer Hours (40 hours minimum) *
Focus should be on work with marginalized populations and not limited to service within your church community.
Your answer
MCAT/DAT SCORE
*or other required test
Your answer
If not taken yet, provide testing date (scores are due March 31) *
Your answer
Are you in the PPHS program? *
Who is your PPHS advisor? (If none, write "None".) *
Your answer
Preferred Committee Lead (choice not guaranteed) (For most, your lead is your PPHS advisor.) (Contact Dr. Hunter with questions about this.) *
Schools to which you're applying: *
Your answer
Year of Application *
Your answer
Goal degree type *
Required
Specific field (if decided)
Your answer
Below, please only enter the names of recommenders who have already agreed to write a letter. (3 minimum)
Title and name of evaluation letter writer #1: *
Your answer
Title and name of evaluation letter writer #2: *
Your answer
Title and name of evaluation letter writer #3: *
Your answer
Title and name of evaluation letter writers (additional):
Your answer
Have you gone through a committee interview before? *
Are you re-applying to professional schools this year?
Which online application system will you be using (AMCAS, AACOMAS, CAS Liaison, ADEA, VMCAS, etc.)?
Your answer
State of Residence *
Your answer
Citizenship *
Please copy and paste your e-portfolio URL
Your answer
Please copy and paste a link to your personal statement
Your answer
Please copy and paste a link to your program research
Your answer
Please note that the process (including interview) will not move forward if you do not communicate with Helen. We look forward to working with you! *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service