Fill out this form to participate in the mentorship program. 

Primary Goals 

  1. To facilitate the matriculation of Asian American pre-med students to medical school by helping to answer question that may arise as students go through the testing, applying, and interviewing process.

  2. To expose Asian American Pre-med students to the medical field from a student’s perspective: life-style of a med student, study habits, pros and cons of being a med student, etc.

  3. To build a strong social network with other young aspiring physicians.  Success is also about who you know, not just about what you know.

  4. To attract more Asian American students to KUMC.  

Need more info? Send email to John Weroha (Program Director), sweroha@kumc.edu

     
Personal Information
  M    F
First Last  Gender
Fr So Jr Sr
Name of School Year in School
What is your Ethnicity?

What year will you apply to medical school? 

What is your undergraduate major?

Contact Information:
Street Address City  State  Zip
E-mail Address Primary Phone #  Alternate Phone #
(w/ area code)  (w/ area code) 

Comments/Requests: 

If you have a preference for a certain type of mentor, i.e. female, male, married, with children etc., please indicate that preference here.

Thank you for submitting your application for the Asian American Pre-med Mentorship Program.  You should receive email confirmation of this application within a few minutes.  We will be contacting you soon.

     

 

Last modified: April 12, 2003