Post-Baccalaureate Certificate Program

Morehouse School of Medicine
Graduate Education in Biomedial Sciences
Master of Science in Medical Sciences Program Application

NOTE: $50.00 application fee required.

Application Fee, Official transcripts, letters of reference, and photo release forms should be mailed to:

Morehouse School of Medicine
Office of Admissions and Student Affairs
Master of Science in Medical Sciences Degree Program
720 Westview Drive SW
Atlanta, GA 30310-1495

NOTE: Any information you submit on this application will not be sold or passed along to a third party (see Morehouse School of Medicine's Privacy Statement).

NOTE: After entering the data into the selected fields, your information will automatically be saved.

APPLICANT INFORMATION

* Last Name

* First Name

Middle Initial

* Date of Birth

* Social Security Number

* Citizenship

Race/Ethnicity

AAMC ID Number

* PREFERRED MAILING ADDRESS (Street and Apartment #)

* City

* State

* Zip Code

Country

* Home Number

Cellular Telephone

Email Address

LEGAL PERMANENT ADDRESS (if different from above)

City

State

Zip Code

Country

How did you learn about the MSMS Degree Program?

PARENT/GUARDIAN

* Full Name

Relationship to applicant:

Parent

Guardian

Other

* Telephone Number

* Mailing Address

* City

* State

* Zip Code

Country

ACADEMIC PROFILE

In chronological order, list all colleges and universities attended and degrees conferred. Write "N/A" in the Degree field if no degree has been conferred.

	Institution	City/State	Major	Degree	Start date (mm/yyyy)	End date (mm/yyyy)
1
2
3
4
5

PREREQUISITES: Please list all prerequisite courses taken and grades earned. One year of each course is required for consideration for the Master of Science in Medical Sciences Program.

	Title	Course Number	Semester Hours	Grade
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

* Overall GPA

* Science GPA

Graduate GPA (if applicable)

Applications will be considered incomplete until all official transcripts from all academic institutions attended have been received. Grades for courses in progress must be received before the start of the program.

If you have not graduated at the time of this application, what is your expected date of graduation?

* Expected graduation date

* MCAT: At least one MCAT score is required at the time of application to the Master of Science in Medical Sciences Program. MCAT scores should not be older than three years. Official MCAT reports should be mailed to the Office of Admissions. Please list the scores and dates of your most recent MCAT examinations.

	VR	PS	BS	WS	Date (mm/dd/yyyy)
Scores 1
Scores 2
Scores 3

If you have not graduated at the time of this application, what is your expected date of graduation?

COMMUNITY SERVICE & HEALTH-RELATED ACTIVITIES

* Please list extracurricular activities in which you have been involved, particularly those devoted to community service, shadowing experiences and any other health-related activities.

	Activity	Position Held	Begin date (mm/yyyy)	End date (mm/yyyy)
1
2
3
4
5

HONORS & ACADEMIC AWARDS

Please list any honors or academic awards you have received.

	Honor/Award	Organization	Date (mm/yyyy)
1
2
3
4
5

SUPPLEMENTAL INFORMATION

* PERSONAL STATEMENT: Please describe your interest in medicine and community service and why you want to attend the Morehouse School of Medicine Master of Science in Medical Sciences Program (500 words max).

0/500 words

* LETTERS OF REFERENCES: A minimum of three letters of reference are required with at least two submitted by science faculty. Please list each of the references contact information below.

Reference letters should be mailed to Morehouse School of Medicine, Master of Science in Medical Sciences Program, Office of Admissions and Student Affairs, 720 Westview Drive, SW, Atlanta, GA 30310.

	Name	Institution/Other	Address
1.
2.
3.

* PREVIOUS APPLICANT: I am a current applicant to Morehouse School of Medicine and would like to use the letters of reference in my AMCAS application.

* In accordance with the Family Education Rights & Privacy Act, as amended, all information regarding decisions on your application is considered confidential. You have the option to elect to have your premedical advisor informed of action taken on your application by the Committee on Admissions.

I wish to have my premedical advisor informed of action taken on my application by the Committee

I do not wish to have my premedical advisor informed of action taken on my application by the Committee.

Not Applicable

* PERSONAL INFORMATION (answer all questions and elaborate below if necessary):

Have you ever attended a post-baccalaureate or graduate program? (If yes, please give the name of the institution and program below)
Have you ever discontinued or been dismissed from any school or college for reasons of scholarship, discipline or health?
Have you ever been convicted of a criminal offense or are there criminal charges pending against you?

If the answer to any part of the question above is yes, please give specific details below:

PHOTO RELEASE FORM: In the event that photos are taken of the applicant while they are enrolled in the Master of Science in Medical Sciences Program, we ask that you download, read and sign the Morehouse School of Medicine photo release form.

I understand that the Committee on Admissions will not consider this application until all supporting documentation has been received, and it is my responsibility to see that these are received by the stated deadline.

I certify that the information provided in this application is complete and correct to the best of my knowledge and belief, and I accept the requirements as stated in the Application and Admissions information guide.

I acknowledge the right of Morehouse School of Medicine to exclude at any time an applicant whose academic standing or general conduct is considered unsatisfactory.

I acknowledge that participation in the MSM Master of Science in Medical Sciences Program does not constitute admission to either the regular M.D. Program or graduate programs.

* Signature (write full name)

* Today's Date

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Thank you for completing the online application for the Morehouse School of Medicine
Master of Science in Medical Sciences Program.

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