2018-2019 Mentor Application
Email address *
First Name *
Last Name *
E-mail *
This address will be used for future correspondence from MSMP. Please notify us of any changes.
Class Standing *
City, state, and country of permanent residence (where you call home) *
High School(s) Attended *
College(s) Attended *
List undergraduate major(s) and minor(s) AND any other degrees earned (e.g. masters, doctoral). *
Are you a graduate of the Imi Ho'ola Program? *
Which of the following best describes your path to medical school? *
What medical schools did you apply to and interview with?
This information will help us in matching as some mentees may identify specific schools that they are interested in applying to.
What do you enjoy doing in your free time?
Examples: playing sports, cooking/baking, playing an instrument, etc.
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Additional Terms