| |
|
|
Thank
you for your interest in Windsor University School
of Medicine. Please complete the form below and
a Windsor Admissions Advisor will contact you
to answer any questions you might have and provide
information regarding how our Premed/MD and MD
program can help to achieve your personal and
career goals. |
| |
| *
Indicates required fields. |
| |
| What
program are you most interested in? *
|
|
| First
Name * |
|
| Last
Name * |
|
| Email
Address * |
|
| Address
Line 1 * |
|
| Address
Line 2 |
|
| City*
|
|
| State/Province *
|
|
| Zip
Code * |
|
| Country *
|
|
| Home
Phone * |
|
| Work
Phone * |
|
|
| Which
is the highest level of education that you possess?*
|
|
| Are
you currently enrolled in another educational
program? * |
|
Yes ( or )
No |
| |
| |
| When
is the best time to contact you?* |
|
Morning |
|
Noon |
|
Mid-afternoon |
|
Evening |
| |
| Time
Zone* :
|
| |
| By
submitting this Student Information Form, I acknowledge
that Windsor University School of Medicine will
contact me via email and telephone.
|
| |
|
| |
| |