Pre-Health Professions Programs Student Summary Sheet
The completion of this summary sheet is a requirement for all pre-health students at the end of each academic year.

Name:(last name, first name)

Local Phone:


Email:



Major:

Academic Advisor:

Prerequisites: (check classes taken)
  Biology 210
  Biology 220
  Chemistry 111
  Chemistry 112
  Chemistry 201
  Chemistry 202
  Calculus
  Physics 105
  Physics 106
  Physics 170
  Physics 171
     
Activities:
Pre-Health Volunteer, Work and Research
For each activity, please provide dates, a contact person and phone number. Include the following information about each activity in the boxes below.
Activity 1: Activity 2:
   
What are your plans for the Summer?
 
   
Did you participate in the Einstein Shadowing Program?
Yes No  
When?