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APPLY HERE: MCAT Prep Scholarship Application
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Name
*
First
Last
Permanent Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
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Colorado
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District of Columbia
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State
Zip Code
Phone
*
Date of Birth
*
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1921
1920
Gender
*
Male
Female
Non-binary/third gender
Transgender
Agender
Genderqueer
Prefer to self-describe
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Residency Status
*
U.S. Citizen
Permanent Resident
DACA Recipient
Other
If you chose other, please provide a description here.
Race / Origin
*
Black/African American
Hispanic/Latino
Asian (South Asian Region, East Asian Region, Southeast Asian Region, West Asian Region, Central Asia Region, and North Asian Region)
Pacific Islander
American Indian or Native Alaskan
Prefer to self-describe
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Are you a veteran or currently serving in the United States Armed Forces?
*
Yes
No
Education
This application is for a student currently identifying as:
*
College Junior
College Senior
College graduate
Non-traditional students* (*includes individuals that have graduated from college more than 5 years ago)
What is/was your undergraduate major?
*
Please list your undergraduate GPA:
*
*If you do not believe your GPA accurately reflects your scholastic capability and achievement, please provide a brief explanation for the discrepancy.*
Expected Graduation Date (or prior graduation date)
*
Undergraduate Institution Name
*
Undergraduate Institution Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
If you pursued an advanced degree (Master's degree, PhD, DMD, etc), What is/was your planned major?
Please list your advanced degree GPA:
Expected Graduation Date (or prior graduation date)
*
Graduate Institution Name
Graduation Institution Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Provide a brief description and explanation (1-2 Paragraphs) of the community activities in which you are involved.
*
Provide a brief description and explanation (1-2 Paragraphs) of your most meaningful leadership experience.
*
Describe any additional circumstances that you believe our review committee should take into consideration.
Recommendation
If you would like to have an individual recommend you, please submit their information below. This is not required but it is highly recommended.
Name
First
Last
Relationship
Email Address
Phone
Essay: One to three-page double-spaced essay (11- 12 pt. font, Arial/Times New Roman) outlining your career goals and where you see your career path leading you. You can include accomplishments relevant to increasing awareness about diversity in your community.
*
Click or drag a file to this area to upload.
Upload your Resume or CV
*
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Upload Headshot
*
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Upload Unofficial College Transcript
*
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Upload Unofficial Graduate Transcript
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Agreement
In submitting this application, I have checked all the forms for omissions and errors and I certify that the information provided is complete and accurate to the best of my knowledge. I understand that falsifying any information may result in the revocation of my application and any scholarship granted to me by Greater Influence Inc.
Do you understand and agree to the terms listed above?
*
Yes, I understand and agree to the terms listed above.
Events, activities, programs and facilities of the University are available to all without regard to race, color, marital status, sex, religion, national origin, disability, age, Vietnam or disabled veteran status as provided by law and in accordance with the University’s respect for personal dignity.
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