Registration - Tour for Diversity in Medicine
Texas A&M University - Corpus Christi Thursday, February 14, 2013
Texas A&M University - Corpus Christi
Date of Birth
I.e. where here you attended high school or the majority of your time growing up
Please assure accurate address
Prior Premedical enrichment Activities (e.g. HCOP, SMDEP)
Other Academic Experiences (e.g. research, volunteering)
I hereby give permission for images of me, captured during the Tour for Diversity in Medicine through video, photo and digital camera, to be used solely for the purposes of Hip Hop Health Inc and the Aetna Foundation promotional material and publications, and waive any rights of compensation or ownership thereto.
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