HS 395 Medical Profession Overview/Honors
This is a fillable form. Enter the requested information and print out a hardcopy for your signature.
This application will be reviewed by the course instructor to determine qualifications for admission to
the course. Please return this application to the Pre-Med Program Coordinator in SB 340 by April 23
(for autumn semester). We recommend that you save a copy of the completed form.
In your completed application, please provide the following materials:
• This cover sheet
• A current UM transcript (an unofficial transcript is acceptable)
• A current résumé (optional – but recommended if you have relevant experience)
Last Name: First Name:
Phone Number: Student ID#:
Major: Second Major: Minor:
What class level will you be during the semester you intend to be enrolled in this course?
Have you completed BIOB 171N (Principles of Biological Diversity)? No Yes
Reason for Interest in the Course:
Experience/Education Relating to the Course:
Student Signature: ____________________________________ Date:
Submit this application to: Pre-Med Program Coordinator, SB 340, The University of Montana—Missoula
APPLICATION DEADLINE: April 23 (for autumn semester).
Late applications may be considered on a rolling basis.