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Medical Dental Preparatory Association (MDPA) Membership form 2018-2019
**Please note that filling out this membership form does not equate membership, all monetary dues must be turned to treasurer (Jacob Litsey) in order to receive benefits such as MCAT discounts, food during meetings, and shadowing opportunities. All students must complete 5 hours of semester each year in order to accumulate points for the Kaplan MCAT course prize.
* Please contact
utamdpa@gmail.com
if you have any questions
OR visit us after each meeting in our office, LS230.
* Required
Name
*
First and last name
Your answer
Membership Dues
*
1 year membership only = $25
1 semester membership only = $20
Email (UTA email preferred)
*
Your answer
Classification
*
Freshman
Sophomore
Junior
Senior
non-traditional
Are you a...
*
Pre-medical student [ medical school]
Pre-dental student [ dental school]
Pre-physician assistant student [PA school]
Pre- nurse practitioner student [NP school]
OTHER
When do you plan on taking the MCAT/GRE/DAT?
by the end of 2018
Winter 2019 to Spring 2019
Summer 2019 to Winter 2020
Not sure yet
Clear selection
Major
Biology/Microbiology
Biochemistry/ Biological Chemistry/ Chemistry
Psychology, Sociology
Other
Pizza Topping Preference
*
Cheese
Veggie
Pepperoni
Thank you for your interest in MDPA
What are the types of information or experiences do you wish to obtain and experience from MDPA?
Your answer
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