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2/24/2019 HMX Fundamentals Public Application - April/May/June 2019 - Personal Information

Personal Information Course Selection Summary Payment

Answer question "Which HMX course(s) are you applying for?"

Answer question "How did you hear about HMX Fundamentals? Select all that apply."

Answer question "Which science courses have you taken previously? Select all that apply."

Answer question "What is the highest degree or level of school you have completed? If currently enrolled, please indicate highest degree received."

Answer question "Which of these categories best describes you?"

Answer question "What are your top reasons for taking HMX courses? (Please select two or fewer.)"

Answer question "In no fewer than 250 words, please explain why you are interested in taking HMX Fundamentals. Please be sure to thoroughly explain your educational/academic goals, you

future career plans, and how you plan to use your studies to achieve your goals. You may also elaborate on your academic and/or personal achievements and life experiences, speci cally focu

on how they relate to your participation in this program. Please do not include your name in your essay, as we do a blind review. We recommend you compose your answer in a separate word

processing program and then copy and paste it here, to prevent accidental loss of data."

Answer question "If applicable, in no fewer than 250 words, please state any special personal or family circumstances affecting your need for assistance and describe what other nancial

assistance you have received to help pay for your current/previous educational experiences (e.g. Pell grants, other tuition waivers, work study, etc.). Please do not include your name in your es

as we do a blind review. We recommend you compose your answer in a separate word-processing program and then copy and paste it here, to prevent accidental loss of data."

Answer question "In no fewer than 100 words, please explain what would you do if you didn't receive this tuition waiver. Please do not include your name in your essay, as we do a blind revie

We recommend you compose your answer in a separate word-processing program and then copy and paste it here, to prevent accidental loss of data."

Answer question "What is your age? Please select one."

Address Address is required.

Address City is required.

Address ZIP/Postal Code is required.

Fill out the information below, then click Next to proceed.

Personal Information

Pre x:

First Name:

Michael

Middle Name/Initial:

Last Name:

Jonatan

Preferred Name:

Gender:

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2/24/2019 HMX Fundamentals Public Application - April/May/June 2019 - Personal Information

*Country of Citizenship:

USA

Institution/Employer:

Job Title (if applicable):

Contact Information

Email Address:

michael.jonatan-13@fk.unair.ac.id

Address:

*Country:

USA

*Address:

*City:

State/Province:

*ZIP/Postal Code:

Primary Phone Number:

Registration Questions

*Which HMX course(s) are you applying for?

Immunology

Physiology

Genetics

Biochemistry

Pharmacology

*How did you hear about HMX Fundamentals? Select all that apply.

E-mail

Advertisement

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2/24/2019 HMX Fundamentals Public Application - April/May/June 2019 - Personal Information

HMS website

Search engine

Word of mouth

Social Media (Facebook, LinkedIn, Twitter, etc.)

Other  

*Which science courses have you taken previously? Select all that apply.

Biology

Chemistry

Physics

Anatomy

Earth Science

Environmental Science

Other  

*What is the highest degree or level of school you have completed? If currently

enrolled, please indicate highest degree received.

Some high school, no diploma

High school graduate, diploma or equivalent (e.g. GED)

Some college credit, no degree

Associate degree

Bachelor's degree

Master's degree

Doctorate degree

Other    

*Which of these categories best describes you?

High school student

Pre-med undergraduate/post bac student

Undergraduate student in a STEM eld

Undergraduate student in a non-STEM eld

Pre-matriculation medical student

Current medical student

Current nursing student

Current PA student

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2/24/2019 HMX Fundamentals Public Application - April/May/June 2019 - Personal Information

Current pharmacy student

Current student in a healthcare eld not mentioned above

Currently employed in health care career

Career changer

Other    

*What are your top reasons for taking HMX courses? (Please select two or

fewer.)

Enhancing candidacy for degree program

Improving academic performance

Preparation for standardized tests / licensing exams

General interest in medicine / health care

Career advancement

Required/recommended by my school

Required/recommended by my employer

Other  

*In no fewer than 250 words, please explain why you are interested in taking

HMX Fundamentals. Please be sure to thoroughly explain your

educational/academic goals, your future career plans, and how you plan to use

your studies to achieve your goals. You may also elaborate on your academic

and/or personal achievements and life experiences, speci cally focusing on

how they relate to your participation in this program.

Please do not include your name in your essay, as we do a blind review.

We recommend you compose your answer in a separate word-processing

program and then copy and paste it here, to prevent accidental loss of data.

*A limited number of partial tuition waivers are available for this program.

Would you like to apply for a partial tuition waiver? (Note: The deadline to

apply for a tuition waiver is Tuesday, February 26, 2019 at 12:00 noon ET.)

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2/24/2019 HMX Fundamentals Public Application - April/May/June 2019 - Personal Information

Yes No

Tuition Waiver Questions


In awarding tuition waivers, we will take into account your answers to the following questions as well as your application as a whole.

*If applicable, in no fewer than 250 words, please state any special personal or

family circumstances affecting your need for assistance and describe what

other nancial assistance you have received to help pay for your

current/previous educational experiences (e.g. Pell grants, other tuition

waivers, work study, etc.).

Please do not include your name in your essay, as we do a blind review.

We recommend you compose your answer in a separate word-processing

program and then copy and paste it here, to prevent accidental loss of data.

*In no fewer than 100 words, please explain what would you do if you didn't

receive this tuition waiver.

Please do not include your name in your essay, as we do a blind review.

We recommend you compose your answer in a separate word-processing

program and then copy and paste it here, to prevent accidental loss of data.

*What is your age? Please select one.

13-17 years old

18-24 years old

25-34 years old

35-44 years old

45-54 years old

54-65 years old

65 or over

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2/24/2019 HMX Fundamentals Public Application - April/May/June 2019 - Personal Information

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