University of Mississippi School of Medicine
Pre-application Counseling Form

Do NOT complete this form until you call the medical school admission office at (601-984-5010) to schedule an appointment.
Appointment Date: Click Here to Pick up the date
Appointment Time :
Firstname:
Middlename:
Lastname:
Suffix:
Address1:
Address2:
City:
State:
Zip:
Telephone:
Cell phone:
Email address:
Confirm email address:
 
High School Attended:
Graduation Date:
Highest ACT/SAT score:
 
College attended:
Major(s):
Graduation date
Estimated Biology, Chemistry, Physics and Math (BCPM) GPA
(Example: 2.56 Must include a decimal point)
MCAT scores
Date VR PS BS WS
I have examined the School of Medicine web page  
Questions I seek answers to: