The Student National Medical Association (SNMA) is searching for motivated, underrepresented, minority 10th and 11th grade high school students who are interested in the sciences to participate in the 2011 HPREP program...

http://weill.cornell.edu/education/student/pdf/2012_HPREP_Application_Packet.pdf

JOAN AND SANFORD I. WEILL CORNELL MEDICAL COLLEGE STUDENT NATIONAL MEDICAL ASSOCIATION HEALTH PROFESSIONS RECRUITMENT AND EXPOSURE PROGRAM (HPREP)

Instruction Sheet

The Student National Medical Association (SNMA) is searching for motivated, underrepresented, minority 10th and 11th grade high school students who are interested in the sciences to participate in the 2011 HPREP program.

The program consists of ten (10) two and a half hour sessions held on Friday afternoons during the months of January, February, and March. Students will attend lectures given by physicians at The Joan and Sanford I. Weill Cornell Medical College. They will also participate in small group workshops led by Weill Cornell medical students. All participants will be required to submit a research paper on an approved topic of interest in medicine at the conclusion of the program. At the end of the program, one participant will receive a College Book Scholarship, to be used during their first year of college enrollment.

To apply the following items must be submitted in a timely manner:

• A completed application form • An official copy of the student’s transcript • Two 250-500 word essays typed in Times New Roman (or equivalent) 12-point font, printed in black ink on plain white paper.

Topic 1: An essay answering these questions: Why are you applying to HPREP? What are your future goals and how do you think HPREP will help you in your future endeavors?

AND

Topic 2: An essay about ONE of the following: 1) Evaluate a significant experience, achievement, risk, or ethical dilemma you have faced and its impact on you. 2) Discuss an issue of personal, local, national, or international concern and its importance to you. 3) Indicate a person who has had a significant influence on you, and describe that influence. 4) Describe a character in fiction, an historical figure, or a creative work (as in art, music, science, etc.) that has had an influence on you, and explain that influence. 5) Describe an encounter that demonstrated the importance of diversity to you.

• One letter of recommendation from a science teacher or guidance counselor who has known the student for at least one year

OR

• Two letters of recommendation, from one of each of the following: A non-science teacher, a supervisor of a community service or volunteer organization in which you are a member, a community leader, an employer, or a family acquaintance.

THESE ITEMS MUST BE POSTMARKED NO LATER THAN

WEDNESDAY, NOVEMBER 2, 2011

IN ORDER TO BE CONSIDERED FOR THE 2011 HPREP PROGRAM

Please send all items to:

Joan and Sanford I. Weill Cornell Medical College Office of Community Service 445 East 69th Street, Room 208 New York, NY 10021-5664 Attn.: Ms. Sahira Torres

All students will be notified of acceptance status by early December. For further information contact Ms. Sahira Torres at (212) 746-3390.

Please turn over for application form

Student National Medical Association Weill Cornell Medical College Health Professions Recruitment and Exposure Program 2012 APPLICATION FORM

Please type or print legibly in black or blue ink.

STUDENT INFORMATION

Last Name First Name Middle I

DOB (mm/dd/yyyy)

Grade

[ ]10th [ ]11th

Sex

[]M []F

Age

Home Address (Include APT number) City, State Zip Code

(Area Code) Phone Number

How would you describe yourself? [ ] Black / African American [ ] Mainland Puerto Rican [ ] Mexican American

[ ] Native American [ ] West Indian

[ ] Other Hispanic (please specify) [ ] Other (please specify)

_____________________________

Email Address

What is your native language?

SCHOOL INFORMATION

School Name (Please Print the Official Name)

School Address City, State Zip Code

School Phone Number

Honors received during high school:

Describe your involvement in extracurricular, community, or school activities:

If you are employed while in school, please describe the type of work and the approximate hours you work per week.

FUTURE PLANS / GOALS

What do you plan to do after you finish high school? [ ] Attend College [ ] Work [ ] Undecided [ ] Other (please specify) ___________________________

ESSAYS

Write two 250 – 500 word essays, one essay on EACH topic listed below. All essays must be typed and enclosed with the application. Put your name on your essays. Topic 1: In essay format, answer the following questions: Why are you applying to HPREP? What are your future goals and how do you think HPREP will help you in your future endeavors.

AND

Topic 2: See Instruction Sheet for topics

DECLARATION

TO APPLICANT: Please read carefully and sign this statement. I declare that the information contained in this application is correct and complete to the best of my knowledge and belief. I understand that any false information given will disqualify me from participation in the program. Also, I am aware that I must submit an official copy of my school transcript and a recommendation that meets the requirements listed on the instruction sheet (please see reverse side). I understand that attendance is required for all ten (10) sessions, beginning at 4:00 P.M., in order to complete the program.

Applicant Signature_______________________________________________________________Date__________________________________________

TO PARENT OR LEGAL GUARDIAN: Please read carefully and sign this statement.

I, _______________________________________________ grant my permission for the above named minor to apply to the HPREP Program, which consists of ten Friday sessions from 4:00-6:30PM. I understand attendance is required for all sessions in order to complete the program, should he/she be accepted.

Guardian Signature_______________________________________________________________Date__________________________________________

Please turn over for instruction sheet