Midwestern University College of Dental Medicine-Illinois

1. Why do you believe that CCOM would offer the type of osteopathic medical education you are seeking? (1500 characters)

2. Why should CCOM accept you into this year's class? (1500 characters)

3. Why do you believe that CCOM would offer you the osteopathic medical education you are seeking?

4. Why should CCOM accept you into this year's class?

1. Have you ever been subject to revocation or suspension of a professional license, or been censured, reprimanded, or placed on probation for reasons relating to professional competence or conduct by a school or licensing authority?

1. List any relatives who are osteopathic physicians:

2. Please upload your CV.

3. Have you been in a paid, employed position for greater than 250 hours in any of the following dental auxiliary careers: dental hygienist, dental assistant, or dental laboratory technician? If so, please provide the following information for each of these paid positions: Name, Address, Phone Number of the practice to confirm hours, and total hours in the practice(s).

1. If applicable, please discuss other responsibilities/employment you may have had concurrent to your undergraduate coursework.

1. List the family members who are Doctors of Osteopathic Medicine (DOs).

1. Upload a copy of your resume or curriculum vitae, which should include, but is not limited to, the following information: Educational History (colleges attended and degrees earned), Employment History, medically-related work and volunteer experiences, college extracurricular activities, honors, and leadership responsibilities, as well as community activities, honors, and leadership responsibilities, and hobbies and nonacademic interests.

2. Have you ever applied/got accepted to any health profession program, or enrolled in a health profession program, then withdrew/got dismissed?

3. For any grades lower than C-minus, please provide an explanation.