2016-2017 APPLICANT PROFILE

Name (First & Last): Preferred Name:

Local Address:

Permanent Address:

Pomona Email Address:

Preferred Email Address:

Preferred Phone Number:

Class Year:Major(s)/Minor(s):

Major Advisor:Senior Exercise Advisor:

Language(s) and Competency Level:

Cumulative GPA*: BCPM GPA*:

Entrance Exam(MCAT, DAT, GRE, etc.):Entrance Exam Score(or expected test date):

Health Profession of Interest (MD, DO, etc.):

*Calculate your cumulative Pomona GPA on a 4-point scale by dividing by 3. Calculate your BCPM GPA on a 4-point scaleby adding the GPA Points earned in each course and divide by the total number of courses, then divide by 3. Include courses listed as Neuro (but not Psych) in BCPM. If difficult to calculate summer course(s) list name of course and grade.

I. RELEVANT EXPERIENCE

List any relevant experiences (limit of 15) with the most recent first. Examples include special study projects and research, employment, internships, volunteering/shadowing, athletics, extracurricular activities, honors/awards, and publications.

Give a brief description of each, including your duties, level of responsibility, and anything else of importance.

Experience / Description (700 character limit including spaces) / Month/Year – Month/Year / Total Hrs

Identify the three most meaningful experiences from the list above. Summarize why you have selected the experience as one of your most meaningful (1325 character limit including spaces per meaningful experience).In your remarks, you might consider the transformative nature of this experience, the impact you made while engaging in the experience, and the personal growth you experienced as a result of your participation.

1.

2.

3.

III. RECOMMENDATIONS

List anyindividualsyou plan to ask for aletter of recommendation (these are separate from the committee evaluation).Individual letters of recommendation are due on Interfolio for the purposes of the committee evaluation byFeb. 28th. More information about Interfolio will be given via the fall and spring trainings.

We recommend:2 natural sciences faculty, 1 faculty from outside the natural sciences,and 1-2 additional recommenders (ex: research, volunteer or internship supervisors, coaches, employers, dance/music instructors, etc.).

The above are general recommendations and may not work for every applicant. Please consider

what combination of recommenders will work best for you and your program of interest.

Last Name / First Name / College/Organization / Department/Title / Relationship/Description of Experience
IV. ACADEMIC/CONDUCT VIOLATIONS

Have you ever been the recipient of institutional action by a college or university for unacceptable academic performance or conduct?

If you answered “yes” or “unsure,” please provide details here and then we will discuss this section confidentially during your applicant meeting.

V. APPLICANT ASSESSMENT

It is important that you are able to step back and assess your developing profile as an applicant to health professions schools. What are the strengths of your developing application profile? What are areas in need of attention? What are ways you can improve your overall application? Consider the following and be honest as you rate yourself according to the following scale.Pleasehighlight a number in each line.

Ratings:1= needs considerable improvement

2= needs some improvement

3= good

4= very good

5= outstanding

Your involvement in health-related experiences1 2 3 4 5

Your involvement in extra-curricular activities1 2 3 4 5

Your ability to present yourself in person1 2 3 4 5

Your ability to present yourself in writing1 2 3 4 5

How well you relate to others 1 2 3 4 5

Ways you exhibit independence/initiative/perseverance1 2 3 4 5

Ways you exhibit leadership skills1 2 3 4 5

Your sense of purpose and motivation 1 2 3 4 5

Your sense of intellectual curiosity 1 2 3 4 5

Your common sense 1 2 3 4 5

Your ability to handle stressful situations 1 2 3 4 5

Your interest in science and biomedical research1 2 3 4 5

Your breadth of interests 1 2 3 4 5

How you have demonstrated commitment to service1 2 3 4 5

Your familiarity with current issues in health care1 2 3 4 5

How you will distinguish yourself as a candidate1 2 3 4 5

How well your professors and advisors know you1 2 3 4 5

Strength of your overall undergraduate/post-bac GPA1 2 3 4 5

Strength of your undergraduate/post-bac science GPA1 2 3 4 5

Strength of your standardized test scores (MCAT; DAT)1 2 3 4 5

AAMC Innovation Lab, 2011

VI. PERSONAL STATEMENT

This is your opportunity to tell your own story of motivation and preparation for a health career in a compelling way that will convince schools to invite you for interviews. This takes thought and more than one draft; therefore, we do not expect the version you will upload with this form will be your final. You will have an opportunity to upload an updated draft prior to your committee interview.For more guidelines on drafting a personal statement, refer to the Pre-Health Website:Apply – Personal Statement.

Make sure to write your personal statement in a separate document and list your first and last name, date, and total number of characters in the top LEFT (review the personal statement character limits below).Then upload your draft to Sakai along with this form and your unofficial Pomona College transcript.
For medical schools the character limit is5,300 including spaces, for dental schools the limit is 4,500 including spaces, and for veterinary schools the limit is 5,000 including spaces.
VII. ADDITIONAL INFORMATION

Is thereany other information you feel would be helpful for the committee to know?

VIII. SUBMISSION

Submission of this form authorizes Pre-Health Advising and the Health Sciences Committee to review the information herein, my personal statement draft(s), and my Pomona College transcript. If there are any changes to my information (address, phone, email, etc.)or applicant status I will notify Pre-Health Advising in a timely manner. I understand that to be included in the committee process I need to upload this completed profile, my personal statement draft (with name, date, andcharacter count), and my unofficial Pomona College transcript to Sakai by Oct. 31st.

□ I agree to the above terms.

Name:Date: