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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 if you have any questions
OR visit us after each meeting in our office, LS230.
Name *
First and last name
Membership Dues *
Email (UTA email preferred) *
Classification *
Are you a... *
When do you plan on taking the MCAT/GRE/DAT?
Clear selection
Pizza Topping Preference *
Thank you for your interest in MDPA
What are the types of information or experiences do you wish to obtain and experience from MDPA?
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