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Pre-Application

PRE-APPLICATION FORM

Each pre-application for admission cycle starts on September 1 and ends on March 30.  Please note that submitting the pre-application form is a separate process from applying for admission to the program.  It is required that you complete this pre-application first.  Also, note that this program is ONLY for educationally and/or economically disadvantaged students during the time they grew up, not in their current status.

The Summary Sheet and Legal Disclosure Forms must also be completed when submitting a pre-application.  Thoroughly complete both forms, save them, attach them to an email and send to msms@iupui.edu.  Your Pre-Application will be on HOLD until these forms are received.  Click here for Summary Sheet and Legal Disclosure Forms.

Personal Information
 
 

 
 
 
 
 
 
Academic Information
MCAT Scores
1st Attempt

2nd Attempt

3rd Attempt

Premedical Science Requirements
Please check all requirements that have been completed.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Overall undergraduate GPA Calculation: For each course: Grade Weight x Credit Hours = Quality Points
Total Quality Points:________ ÷ Total Hours: ________= Overall undergraduate GPA: ________

Science* GPA Calculation: Total Science Quality Points: ________ ÷ Total Science Hours: ________=
Overall Science GPA: ________

*Science = Biology, Chemistry, Physics, and Math
Freshman
Sophomore
Junior
Senior

Post-Baccalaureate

Graduate

 
 
 
 
 
 
If yes, complete the following four fields:
Medical School Application Dates:
Disadvantaged Student Status
 
 
Applicant is considered "educationally disadvantaged" if he/she "comes from an environment that has inhibited the individual from obtaining the knowledge, skills, and abilities required to enroll in and graduate from a undergraduate college or health professions school.

Reference from http://msms.iu.edu/admissions/eligibility
The term "educationally disadvantaged" refers to both educational and social disadvantage
%%(1) Such as coming from a low-income family
%%(2) Limited English proficiency families (English as a second language)
%%(3) The individual graduated from (or last attended) a high school that was on probation and/or received low per capita funding (Per student expenditure)
%%(4) The individual graduated from (or last attended) a high school/middle/elementary at which, he/she was eligible for free or reduced price lunches
%%(5) The individual comes from a family that received public assistance (e.g., Aid to families with dependent children, food stamps, Medicaid, public housing)
 
 
If you checked yes the following site will allow you to confirm your economically disadvantaged status. This table will allow you to compare your 2015 earnings to the amount you are allowed under economically disadvantaged.

Family income levels are employed to evaluate economic disadvantage.

Reference from http://msms.iu.edu/admissions/eligibility "Family Income Levels"
Please check all that apply:
 
 
Record the amount of family taxable income (if claimed as a dependent) or your personal taxable income, reported to the IRS for the most recent tax year.
Individual Return:
 
 
Please check all that apply:
 
 
 
 
 
 
 
Please briefly describe the health disparity issues of your community. Briefly describe your past involvement in that community and potential role as a physician in meeting the health disparity challenges of your community?
 
 
 
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MSMS | MS 203 | 635 Barnhill Drive | Indianapolis, IN 46202 | Phone: 317-278-1724 | Fax: 317-278-5364