Virtual Program 2020 Registration

for
African American/Black and Underrepresented Minority Students Who Want to Become Physicians

Make sure you complete entire form.
Deadline for form submissions is Friday, August 14, 2020 at 9:00 P.M. PST

Important: Double check your email to make sure it is listed correctly. This is the only way you will be admitted to the virtual program so please make sure this is the email you will be using.

Important: Please make sure you are the students registering for the program. Parents/guardians, please do not register your email address for your students. Students should only submit an email address they will use.

Important: Make sure that the number you provide is correct and one you will have access to the day of the program.

If yes, you will receive an email with the pick-up location. Please remember to frequently check your spam/junk folder.