Items Required on ERAS Application

Items Required on ERAS application

(This information is required on the ERAS application form)

Name____________________________

Address:_________________________                               Home:_____-_________

               _________________________                               School _____-_________

                _________________________

               __________________________                             Married:____Single____

Parents’ Name, Address:_______________________________

                                           _______________________________

                                           _______________________________

                                          Telephone: ____-_________

Undergraduate School_____________________Rank_______GPA_____

U.S.  Medical School_____________________Class Standing______________

              (Xerox copies are acceptable except for Dean’s Letter which

              must be original)

AOA:              Yes_____        No______       National Boards Score: I___II____

Honors:____________________________________________________________

              ____________________________________________________________

               ____________________________________________________________

Research Experience:_________________________________________________

         _______________________________________________________________
         _______________________________________________________________
Publications:________________________________________________________
                      ________________________________________________________
                      ________________________________________________________

 

Noteworthy Accomplishments:_________________________________________

____________________________________________________________________