Test Form Application For Merit Award Pre-Dental Students Updated Eligibility Eligibility * Female Muslim. Parents are not physicians (an exception will be made if parents never practiced as physicians). Currently enrolled as a pre-medical or dental student at an accredited university or graduate school. Minimum cumulative GPA 3.50 is required. Attached transcript from university indicating Enrollment. Copy of resume. Send your official letter of school enrolment. Professional Photo required. Upload Picture * Drop a picture here or click to upload Choose Picture Maximum file size: 25MB Please upload professional portrait photo 2 x 2.5″ (Width: 192px Height: 240px) Attach Transcript * Drop a file here or click to upload Choose File Maximum file size: 25MB Copy of Resume * Drop a file here or click to upload Choose File Maximum file size: 25MB Letter of School Enrolment * Drop a file here or click to upload Choose File Maximum file size: 25MB Personal Information First Name * Middle Name Last Name * Date of Birth * Phone * Email * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Academic Information University * Major(s) * Year/Term * Degree(s) Pursued * Expected Grade Date * Section To be attached: Professional goal statement, 500 words or less – Professionally where do you see yourself in 10 years and please tell us how you will contribute to AMWPA in the future? 0 of 500 max words Please tell us what you can do for AMWPA now while you are in school? (Ex. starting a local AMWPA chapter at your school, volunteering for health fairs, etc) What else would you like the committee to consider upon reviewing your application? (Hardships, notable accomplishments, etc.) 0 of 500 max words Terms & Condition * I agree to join AMWPA after graduation from medical / dental school/allied health and be an active member of AMWPA. Also agree to get the pic posted on AMWPA website if you get the award and no changes will be made to that pic. (Note: Recipients of merit awards will be given free membership to AMWPA for 1 year after graduation and then will be required to continue being active members of AMWPA by paying dues annually to be part of the organization. Submit If you are human, leave this field blank.
