NATIONAL IDENTIFICATION NUMBER
US Social Security No.
Canadian Social Insurance No.
HOME TEL. #:
ALTERNATE TEL. #:
Are You Can/US Citizen or Permanent Resident?
If non-Canadian and non-US Citizen:
Check here if you completed the GED instead of graduating from high school. Indicate all high schools attended in the space provided above. Have your official GED scores as well as transcripts from last high school sent directly to us.
Are you currently enrolled in a College/University**?
If yes, please complete: Name of College/University and in which Country:
*NOTE: An official transcript must be sent from each college attended, including summer credits. Failure to list all schools, colleges and universities may make you ineligible for admission. A decision cannot be made until all transcripts have been received. Begin with most recent institution attended, and be sure to complete all requested information. Attach a separate sheet if necessary.
Intended Admission Program**:
5 Year MD Program - min Gr.12 highschool
3 Year 4 Month MD - min 2 yrs uni or equiv
MD Clinical Science - completed Basic Sc.
BSc. Medical Science
PROPOSED TERM OF ENROLLMENT:
HAVE YOU EVER BEEN WITHDRAWN FROM AN INSTITUTION?
IF YES, WHY?
HAVE YOU EVER BEEN ARRESTED OR CONVICTED?
IF YES, WHY?
HAVE YOU EVER BEEN TREATED FOR SUBSTANCE ABUSE?
*****Please Complete Your Personal Statement. You may mail it separately if you wish (Minimum 1 page, maximum 2 pages). Create a rounded portrayal of yourself, and state why it is that you want to become a doctor. Describe any special achievements or talents that you possess, any personal experiences, responsibilities and/or challenges that have impacted you or your academic achievements.*****
© Copyright All Saints University, St Vincent and The Grenadines | Last Updated:
Wednesday, 7 December, 2011
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