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Upperclassmen Pre-Medical Community Online Application

The Upperclassmen Pre-Medical Community is a living and learning community of sophomores, juniors, and seniors who are preparing for application to medical, dental, optometry or veterinary school. The community is designed for students who want the synergistic benefit of living with fellow students with similar career goals, are interested in having a valuable experience volunteering in a health care setting, and would like to mentor first-year students who are also on their road to medical school.

Have you completed the standard housing application online through VIP located at http://www.vip.sc.edu? If no, DO NOT submit this application. We can not consider your request without a paid housing application on file with the University of South Carolina.
Last Name:
First Name:
Middle Name:
Email Address: [REQUIRED]
Term applying for:
Local Mailing Address:
City:
State:
Zip:
Local Phone (including area code):
Cell Phone (including area code):
Date of Birth:
Gender:	Male Female
College Major:
Anticipated Graduation Date:
University of South Carolina GPA:
Interest in:
Medicine Dentistry Optometry Veterinary Other:
Roommate Preference (not required):
a. Preferred Roommate’s Name:
Preferred Roommate’s Date of Birth:
b. Is he/she applying for the Upperclassmen Pre-Medical Community?
Yes No
Respond to the following questions: 1. List hobbies, extracurricular activities, and organizations, which you have participated in during college, as well as any leadership positions you have held:

2. Why are you interested in joining the Upperclassmen Pre-medical Community? What do you hope to gain from this experience?

3. How would you contribute to the Upperclassmen Pre-medical Community?

4. Describe your goals related to the health/medical field:

5. Please describe any volunteer or work experience you may have had in a medical/health care setting:

Please read the following information and place a check in the box indicating that you have read and understood the requirements for the Upperclassmen Pre-Medical Community.
If chosen as a resident of the Upperclassmen Pre-Medical Community, I will agree to the following:
1. Maintain good academic (3.0 minimum) and disciplinary standing with the University
2. Abide by the community standards.
3. Uphold the tenets of The Carolinian Creed
4. Mentor an assigned freshmen pre-medical student
5. Complete three hours of health field community service per week (including having community service arrangements made and approved by the Office of Pre-Professional Advising by August 1, 2006)
6. I understand if I do not abide by this agreement, I may be subject to removal from the community.
All applicants must complete an interview. Please list the times that you are available for a 15-minute phone interview:


Signature:
Date:

Columbia, SC 29208 • 803-777-2481 • housing@sc.edu