AHEC Scholars Application

  • Part 1: APPLICANT INFORMATION

  • Name
  • Permanent Address * Required
  • Race/ Ethnicity * Required
  • Do you speak any languages other than English? * Required
  • Part 2: ACADEMIC INFORMATION

  • In which institution are you currently enrolled? * Required
  • Discipline/Program enrolled: * Required
  • Date Format: MM slash DD slash YYYY
  • Part 3: FAMILY/BACKGROUND

  • Are/Were you the first generation in your family to attend college? * Required
  • Are you/ Will you be the first person in your family to receive a bachelor's degree? * Required
  • Have you previously participated in any UAMS pre-health careers programs? (For example: MASH, CHAMPS, MCAT Prep @ ASU, Day in the Life, Pre-Professional Advising) * Required