OUM Student Candidate Application

 

OUM Student Candidate Application

  
 

Welcome to the Oceania University of Medicine on-line application.

Application Fee: The application fee of $100 USD must be received before your application begins processing. A personal check or money order can be forwarded to the address above, made payable to Oceania University of Medicine. Major credit card information may be faxed to 888-670-8512.

Please check that all details are correct and complete (* indicates required information). If you have difficulty completing the online application, please click here to contact the Admissions Office.

     

 

 Personal Details  

 

Full Name: *

  

 

Date of Birth: *

  mm/dd/yyyy         
 

I am a citizen of: *

  
 

Country of birth: *

  
 

Social Security #: *

  
 

or National ID Number:*

  
 

Passport Number:

  
 

Passport Place of Issue:

  
 

Visa Status:

  
 

Native Language:

  
 

English Language Fluency:

  

 

   Address  
 

Street Address: *

  
 

City: *

  
 

State, Province: *

  
 

Postal Code: *

  
 

Country: *

  

 

   Contact Information
(please include the country code if outside the US or Canada)
  
 

Home: *

  
 

Mobile:

  
 

Work:

  
 

Facsimile:

  
 

Email Address: *

  

 

   Employment History  
 

1. Employer:

  
 

Employed From (dates):

  Through:    
 

Position / Title:

  
 

2. Employer:

  
 

Employed From (dates):

  Through:    
 

Position / Title:

  
 

3. Employer:

  
 

Employed From (dates):

  Through:    
 

Position / Title:

  
 

4. Employer:

  
 

Employed From (dates):

  Through:    
 

Position / Title:

  

 

   Academic Details/ History
(use the first or last day of the month if exact dates are unknown)
  
 

MCAT Score:

  
 

Date Taken:

  mm/dd/yyyy  
 

or Planned Test Date:

  mm/dd/yyyy           
 

GAMSAT Score:

  
 

Date Taken:

  mm/dd/yyyy  
 

or Planned Test Date:

  mm/dd/yyyy           
 

Fellowships, Scholarships, or Other Honors

  
 

1. College Attended: *

  
 

Attended From (dates):

  Through:    
 

Degree:

 
 

Major: *

  
 

GPA (must be numeric): *

  
 

2. College Attended:

  
 

Attended From (dates):

  Through:    
 

Degree or Major:

  
 

Major:

  
 

GPA (must be numeric):

  
 

3. College Attended:

  
 

Attended From (dates):

  Through:    
 

Degree:

  
 

Major:

  
 

GPA (must be numeric):

  
 

4. College Attended:

  
 

Attended From (dates):

  Through:    
 

Degree:

  
 

Major:

  
 

GPA (must be numeric):

  
    Letters of Recommendation will be forwarded from:  
 

1. Reference Name:

  
 

Reference Title:

  
 

Reference Telephone:

  Ext.   
 

Reference Address:

  
 

2. Reference Name:

  
 

Reference Title:

  
 

Reference Telephone:

  Ext.   
 

Reference Address:

  
 

3. Reference Name:

  
 

Reference Title:

  
 

Reference Telephone:

  Ext.   
 

Reference Address:

  
 

 

  
    General  
 

How did you hear of OUM (Ad, Letter, Postcard, Web, etc): *

  
 

Referred By (Name of Magazine, Search Engine, Person, etc):

  
 

Have you spoken with a representative from OUM? *
 

 
 

Do you have good computer skills? *

  
 

Do you own a laptop computer? (This is not necessarily a requirement) *

  
 

Do you need to apply for financial aid? *

  
 

Desired Degree *

  
 

Do you waive the right to access reference information? *

  
 

If you are accepted by OUM, what starting date would you prefer? *

  
 

Why do you want to become a Physician, and why are you considering OUM? *

 
 

Any other information you think might be helpful to us in making a decision.

  
 

Please check all details are correct and complete.

  
 
 
 
     
 


 

 
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