DATE RECEIVED BY PHCAP: __________
RESOURCE FOR RECOMMENDATION PREPARATION
TUSKEGEE UNIVERSITY
PREPROFESSIONAL HEALTH CAREERS ADVISORY PROGRAM (PHCAP)
The purpose of your filling out this form is to provide the PHCAP Committee with information useful in writing its composite letter of recommendation (the cover letter for your recommendation package.) The more detail we have, the more we can use in the letter. Failure to provide vital information will slow down the entire process. Failure to provide information about experiences that are not a part of your academic record means we simply will not know about those things and cannot refer to them in the letter written for you. Give thorough documentation of honors, research, volunteering, etc. because we have no other source of that information. (For example, which summer did you do that summer program; how long was the program; what was the name of the program?) Add pages if necessary. Be sure that you can DOCUMENT for the medical school anything that you list; they may ask for documentation. If new information becomes available after submission of this form, submit it as an addendum.
NAME _____________________________________________________________________
(PRINT) LAST FIRST MI
LOCAL ADDRESS ______________________________________________________________
LOCAL PHONE ___________ CELL PHONE _________________email _____________________
HOME ADDRESS __________________________________________________
__________________________________________________
HOME PHONE NO. _________________________
MAJOR: _______________ ACADEMIC ADVISOR: ____________________CURRENT GPA: ________
I hereby give the PHCAP Committee permission to access my academic record. _______________________________ __________
signature date
You must supply the PHCAP Committee with the following:
1) A copy of your application's PERSONAL ESSAY. (If you give us a draft of the essay before you submit it, we will provide feedback.)
2) A copy of your MCAT, DAT, OAT (or other) entrance examination scores. (If you release scores to health professions advisor at the time you take the test, that is sufficient.)
DATE of Exam: _____________ Did you release scores to Advisor? ___________
SCORES: __________________________________
DO YOU AGREE to the PHCAP Committee's displaying on the PHCAP Bulletin Board an announcement of your acceptance to professional school? ______Yes ______ No.
Return materials to:
Cynthia Ann Jackson, Chair, PHCAP Committee
Department of Biology, Tuskegee University, Tuskegee, AL 36088
If problems/questions: contact [email protected] or phone (334) 727-8063 or FAX (334) 724-3919
Mr. Wise in 207 Armstrong, (334) 727-8832.
HONORS/AWARDS for Scholarship, Citizenship, Athletics, etc (What? When? In recognition of?)
__________________________________________________________________________________
__________________________________________________________________________________
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LEADERSHIP
_______________________________________________________________________
HOBBIES, SPORTS, CLUBS, OTHER EXTRACURRICULAR ACTIVITIES (Dates?)
___________________________________________________________________________________
___________________________________________________________________________________
RESEARCH EXPERIENCE (Where? Name of Program/ Project? Supervisor**? Dates? )
__________________________________________________________________________________
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CLINICAL EXPOSURE (Summer enrichment programs, Hospital volunteering, shadowing: Duties? Where?)
__________________________________________________________________________________
__________________________________________________________________________________
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OTHER SERVICE ACTIVITIES NOT CITED ABOVE (Tutoring, volunteering)
___________________________________________________________________________________
___________________________________________________________________________________
JOBS HELD WHILE A STUDENT (What? Dates? Number hours/week? Responsibilities? )
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HOW DID YOUR DESIRE TO ENTER THIS PROFESSION ORIGINATE?
___________________________________________________________________________________
___________________________________________________________________________________
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ANY RELATIVES IN THE HEALTH CARE PROFESSIONS (What relation to you? What professions?)
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WHAT WILL BE YOUR SPECIALTY ? ________________ WHERE PLAN TO OPEN OFFICE? ________
ADDITIONAL COMMENTS? (Optional, Make on separate sheet as desired.)
ABOUT DR JOHN BEGGS JOHN BEGGS RECEIVED HIS BS
ADVERTISEMENT FOR BID SEPARATE SEALED BIDS WILL BE RECEIVED
APD14200 DEREGISTRATION APPLICATION RECEIVED AT LOCAL OFFICE
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