The Populi Foundation - Mentee Application
This application is mostly for us to get a snapshot of where you are and what we can help you with! If you're a first year, you may not have a GPA or any extracurricular involvements just yet. As a second year, you might still be figuring out whether you want to be involved in research or not. And that's totally ok!

Just fill out as much of the form as you can so we can get you set up with a mentor best suited to work with you!

Please keep in mind that this is an application for a MD or DO medical student mentor. We unfortunately do not have PA mentors at this time.
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First Name *
Last Name *
Prounouns
Undergraduate Institution *
Year in School (2022-23 Academic Year) *
Anticipated Graduation Date *
Major/Anticipated Major *
Premed requirement grades (by class)
Current GPA
Extracurricular Involvements (please list)
Service Involvements (please list)
Research Experiences (please list)
Leadership/Misc. Involvements (please list)
What do you believe you need or are looking for help with through our program? Check all that apply *
Required
Does your school have a premed advisor or office? *
If your school has a premed advisor/office, do you use it?
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If you do not use your school's premed advisor/office, why not?
Have you taken the MCAT yet? *
If so, what is your highest score?
Are you a first generation college student? *
Is anyone in your family a physician? *
Do you qualify for the AAMC's Fee Assistance Program? Please refer to the table pictured below *
AAMC Fee Assistance Program Guidelines
If not, what is your family's estimated income? *
What are some of your hobbies and/or interests? *
What best defines your race/ethnicity? *
What best defines your gender? *
Phone number *
Email Address *
City *
State *
Zip Code *
Can you commit to our professionalism requirements, which include the following (please check boxes)
Is there anything else you would like to share? For instance, if you do not qualify for the Fee Assistance Program but are still disadvantaged, please explain.
How'd you hear about our program?
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