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1. Welcome!

Welcome to the 2013-2014 academic year at University of Dayton! Please provide the following information so that we can provide you with up to date information and resources of the Premedical Programs Office.

1. Please complete the following sections.

Today's Date

2. Demographic Information:

3. Current Status:

4. Please provide your 2013-2014 CAMPUS ADDRESS.

NOTE: If you are in campus housing:
* Enter your 4 digit zip in the space provided.
* Leave City and State spaces BLANK.

* 5. Please provide your PERMANENT ADDRESS and phone.

6. What is your current MAJOR?

* 7. Who is your current advisor?

8. Who is your MED/DEN advisor? (Will be the same as academic advisor for MED/DEN majors.)

9. Anticipated Graduation Year

10. Which of the following resources would you find helpful for receiving information from the Premedical Programs Office?

  Definitely Valuable Somewhat Valuable Not Valuable
Mailed Copy of Newsletter
Premed Programs Website

11. Which of the following careers is of interest to you?