Student Information Form
Name: ___________________________________ Graduation Year: ______
Campus Address: ________________________________________________
E-mail address: _________________________________________________
Do you have a double major? _______________________________________
What is your minor? ______________________________________________
Have you taken pre-med core? ______________________________________
Are you planning to pursue post-secondary education? If so, what type school are you planning to attend?
Law School
Medical School
Nursing School
Graduate School (in what discipline?) _________________________
Projected career goals: ______________________________________________________________
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Information about MHS-related extra-curricular interests, activities, volunteering:
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