Doctors On Board
Community Health

2022 Student Application

Please make sure you complete the entire form.
Deadline for form submission is Friday, March 25, 2022 at 5:00 P.M.

We are no longer accepting applications for the 2022 program. Thank you for your interest.

default text

If not, you can register at

Underrepresented Minorities in Medicine (URM) Who Want to Become Medical Doctors
Note: If you are under 18 years old, you must provide the following info:


A headshot photo will be requested if you are accepted into the DOB/CHI Program. This photo will be used primarily for the closing ceremony and the team presentations. It may also be used in program and promotional materials. Make sure this photo is professional looking. No sunglasses, cars, inappropriate attire or gestures. Please make sure you are the only person in the photo. These photos may be seen by college/university program admissions and administrators. See sample image.

Sample Photo