MEDacademy Application

Have you previously completed MEDacademy I in a prior summer term?

Yes

No

Please complete this application for consideration for MEDacademy. This application is only for phase one (i.e. those who have not previously participated in the program). Official school transcripts must be emailed from an official school employee (their work email address) and should be sent to MEDAcademy@rowan.edu. Official school transcripts can also be mailed to:

MEDacademy Summer 2025
Cooper Medical School of Rowan University
401 South Broadway
Camden, NJ 08103

Please complete this application for consideration for MEDacademy II (MED Master’s). This application is only for phase two (i.e. those who have previously completed MEDacademy phase one). Official school transcripts must be emailed from an official school employee (their work email address) and should be sent to MEDAcademy@rowan.edu. Official school transcripts can also be mailed to:

MEDacademy Summer 2025
Cooper Medical School of Rowan University
401 South Broadway
Camden, NJ 08103

Biographical Information

First Name

Middle Name

Last Name

Preferred First Name

Sex

Birthdate

Primary Citizenship

U.S. Permanent Resident?

Contact Information

Email Address

Mobile Phone Number

Home Phone Number

Permanent Address

Country

Street

City

Region

Postal Code

Mailing Address

Same as Permanent Address

Country

Street

City

Region

Postal Code

Academic Information

High School

Graduation Date

School Grade

Overall GPA

Science GPA

Other Interest

List extracurricular activities, including volunteer experience, leadership roles and hobbies

List employment experience

Have you participated in JUMP?

Year participated

Parent 1 Information

Full Name

Email

Phone Number

Highest Level of Education

Occupation (N/A if not applicable)

Parent 2 Information

Full Name

Email

Phone Number

Highest Level of Education

Occupation (N/A if not applicable)

Household Information

This information will be used primarily to make scholarship decisions for MEDacademy, should there be funds available. Please note that this question must be answered if you would like to be considered for MEDacademy scholarships. CMSRU may request documentation during the application process to verify this information, so it’s important to be as accurate as possible.

Person(s) in family/household

Recommenders

Upon submission of your MEDacademy application, the following recommenders will be sent the recommendation form to fill out on your behalf.

Recommender 1 First Name

Recommender 1 Last Name

Recommender 1 Email

Recommender 2 First Name

Recommender 2 Last Name

Recommender 2 Email

Essay

Please explain, considering our mission, what you hope to gain from participating in MEDacademy.

Scholarship Essay (Optional)

If scholarship funds become available, they will be disbursed based on need. If you would like to be considered, please state why you feel you should be selected as a scholarship recipient.

PLEASE NOTE: If you don't answer this question, you will not be considered for scholarship opportunities. Additionally, we may request documentation of your household income (W-2 or other forms) for verification of any scholarship disbursement. This information will only be used for scholarship purposes.

Ethnicity and Gender The questions in this section are optional. No information you provide will be used in a discriminatory manner.

Gender

What is your ethnicity?

Hispanic or Latino

Not Hispanic or Latino

Prefer not to answer

Regardless of your responses above, please choose one or more race categories from the list below

Do any relatives work or have they ever worked at Cooper University Health Care or Rowan University?

Yes

No

Name and Title

How did you hear about MEDacademy, please be as specific as possible.

I certify that, to the best of my knowledge, all the information provided in this application is true and complete. CMSRU reserves the right to cancel either phase of the MEDacademy program. In the event that the program doesn’t take place, all deposits will be returned.