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New Jersey Medical School (UMDNJ) Supplementary Application


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1. Please indicate if you would like additional information for any of the following joint degree programs:

MD/PhD MD/MPH MD/MBA

 

2. If your legal residence on your AMCAS application is not New Jersey, you will be considered an out of state resident. If this is the case, please answer the following questions:

 

2a. Please describe the specific and/or unique reasons you have applied to NJMS. Please respond in 1000 characters or less.

 

2b. Please discuss any significant connections to New Jersey (i.e. family, close friends, previous residence, etc.) Please respond in 1000 characters or less.

 

3. Have you participated in any Educational/Pipeline Programs at NJMS? Yes No

3a. Name of program(s): Date(s):

 

4. Do you have any relatives who have graduated from a UMDNJ affiliated institution? Yes No

4a. Please elaborate:

 

5. Do you have any other affiliations with NJMS? Yes No

5a. Please elaborate:

 

6. If you are not attending college/university full-time as of September 2010, please describe your activities for July 2010 to June 2011. Please respond in 3000 characters or less.

 

 

7. I agree that UMDNJ-New Jersey Medical School may request and I hereby authorize all appropriate sources, such as educational institutions and employers, to release transcripts and any other information to the Admissions Office for purposes of confirming or supplementing information contained in my application or relating to the admissions process.

 

8. I understand that, as a condition of admission, I am required to authorize UMDNJ-New Jersey Medical School to obtain criminal background check(s). I may also be required to obtain a background check myself or authorize clinical training facilities to conduct this check, and to permit the results to be provided by the reporting agency to UMDNJ-New Jersey Medical School and/or to clinical facilities.

 

9. I understand that as per UMDNJ-New Jersey Medical School policy, every student accepted to NJMS will be required to complete the Student Health Immunization requirements and submit the necessary forms prior to matriculation. I also understand that I will be unable to use my student health insurance to cover the cost of these requirements because satisfaction of these requirements is due in advance of student health insurance activation.

 

10. I certify that the information submitted on this application is complete and accurate. I understand that failure to provide complete and accurate information may affect my admission. I also understand that my application will not be considered until the Office of Admissions receives all the necessary documents.

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