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Profession: Profession:
Studying now (BS/ MS/ PhD, DDS etc) _______________ Year 1 2 3 4 5 (circle)
MCAT: Yes / No: Score: Biology:__________ Physics: __________ Verbal: _________ Writing: __________
(not essential)
Took illicit drugs any time Yes / No Have you been arrested by police any time: Yes / No
LLC (ADA)
Study Medicine Abroad
Int’l Consultants & Placement Specialists, USA
Web: www.AmericanDreamAbroad.com Ph: 248-419-0284
Email: info@AmericanDreamAbroad.com or EasyMedSchool@yahoo.com 209-832-3111
Tell us about you: (Why you want to become a Doctor? Motive– your plans- in 10 years- in a few words)
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_____________________________________________________________________________________
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Page 3 of 4
,LLC (ADA)
Study Medicine Abroad
Int’l Consultants & Placement Specialists, USA
Web: www.AmericanDreamAbroad.com Ph: 248-419-0284
Email: info@AmericanDreamAbroad.com or EasyMedSchool@yahoo.com 209-832-3111
Applicant’s Declaration
I certify that the information and answers given by me in my application to American Dream Abroad, LLC (ADA), and in this admission process are
accurate and complete to the best of my knowledge and belief. I am aware that the Admissions Committee of ADA, the placement firm, in the first
step screens, verifies and evaluates my application and decides to select me and will let me know. In the next step matches me with the best
possible school and facilitates my admission into the medical school on payment of the admission fee. I know ADA has agreements with many
medical schools/colleges/universities abroad. The worldly – international or national, governmental or non-governmental bodies like the medical
councils, commissions or organizations etc themselves decide/ vary the recognition of the universities, medical schools/colleges and their degrees
at their own discretion. I am aware the medical school decides the rules, regulations, facilities, fees, curriculum, the duration of the courses,
policies etc all the time and they may vary from one school to another. I shall abide by the policies, rules and regulations of the medical school/
college/ university and ADA and their rules or conditions may vary at any time without notice and I know that all fees are nonrefundable. I know
that ADA’s role is limited to facilitating my admission into one of the medical schools/ colleges/ universities. I declare that I have no physical and
psychological disabilities, which come in way of my stay, study and/or behavior at the medical school.
I request ADA to find me a place and facilitate my admission into a meritorious medical school/ university, which had been teaching in English for
long time. If I get selected and admitted in medical school, I am aware that ADA is in no way liable for any occurrences or events, which I may
experience anywhere at any time, before, while or after attending and also while traveling to/ from the university Medical school. I further agree
that jurisdiction for any or all actions against the affiliate university, medical school, ADA, their owners, members, staff, officers or associates lies
solely within the city of the affiliate school/ university’s physical location, and that all actions will be remanded to arbitration within that city and I
further agree to bear all the costs of litigation any time if any need arises at all.
I appreciate and thank ADA for making me aware of this beautiful opportunity of medical school admission thru its extensive and expensive
advertisements in different media like News papers, TV, Radio etc and also thru publicity campaigns, kiosks, open houses and seminars and also
providing me its service.
I would be thankful to ADA, if I get admission thru this selection process, for helping me get into a medical school to make my dream of becoming
a doctor a reality.
If I get admitted I promise to be a disciplined and motivated student and do hard work to learn the art and science of medicine. I shall work for the
good of the mankind. I know every human life is precious and I promise to preserve and protect it.
I know it is a beautiful responsibility. I shall remember this and behave in a disciplined way, learn medicine, not get deviated or diverted from that
path and serve the humanity to the best of my ability.
Name and phone numbers of the parent/ spouse, who signed above: Mrs / Mr ___________________________________________ ______
Please do not leave any blanks. >>>>>>>>>>> End of Application. <<<<<<<<<<<< Page 4 of 4
,LLC (ADA)
Study Medicine Abroad
Int’l Consultants & Placement Specialists, USA
Web: www.AmericanDreamAbroad.com Ph: 248-419-0284
Email: info@AmericanDreamAbroad.com or EasyMedSchool@yahoo.com 209-832-3111
Info sheet
Checklist
Please send
1) Application- completed and signed.
2) Diplomas from High School/ College (if ready) -- copies
3) Transcripts (if available- if not send later.)
4) Passport ‘photo page’ copy (for your exact name & number for the visa documents from the government, we get for you.)
5) 3 Photos (2”X 2”)
6) Application fee with a bank/ official check
If some documents are not ready/ pending, you can send now the application with the presently available documents and the fee
for speeding up the process.
You can send the other documents later when available. Don’t wait for them. (Early Bird catches the worm.)
Your schools or you can fax the transcripts to speed up the process followed by mail.
Send only copies. No documents will be returned from us.
We would be happy to take you into our reputed long lasting University Medical School program, if you meet the criteria.
We try to help all the applicants, who has the right attitude to enter into our noble medical profession to help others.
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Ph: 248-419-0284
209-832-3111
Cell: 248-635-1110 (only if we are not available at the above numbers please.)