E. Experience #5

Click on the

image in the upper right hand corner to enter this information.

For each experience entry, choose from the following list the experience type that best describes each experience.

• Physician Shadowing/Clinical Observation

• Paid Employment—Medical/Clinical

• Paid Employment—Not Medical/Clinical

• Community Service/Volunteer—Not Medical/Clinical

• Community Service/Volunteer—Medical/Clinical

• Conferences Attended

• Presentations/Posters

• Publications

• Extracurricular/Hobbies/Avocations

• Research/Lab

• Leadership—Not Listed Elsewhere

• Teaching/Tutoring/Teaching Assistant

• Honors/Awards/Recognition

• Other

Experience Type (see list above):

Experience Name Dates Start (month/year): End (month/year):

Average Hours/Week:

Organization Name:

Country:

City:

Contact Name: Contact Title:

Contact’s Phone: Email Address:

Experience Description: The available space for each description is 700 characters (including spaces).

□ Most Meaningful (highlight if you feel this is one of your most meaningful experiences and fill in the information below)

ONLY fill out the Experience Summary below if you indicated this experience and "most meaningful"- you can only identify up to 3 activities as most meaningful.

Experience Summary: The available space for each description is 1325 characters (including spaces).