OUM Student Candidate Application

 
 

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

Supplemental Documents: Please arrange for your college transcripts and three letters of recommendation to be mailed directly to Oceania University of Medicine Admissions Office, 9700 South Dixie Highway, Suite 620, Miami, FL 33156, USA.

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 e-Medical Education, LLC. Major credit card information may be faxed to 1-305-670-3100.

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.

 
    Application Fee Payment  
 

Credit Card #

 
 

Expiration (mm/yy)

 Code   
 

Please check all details are correct and complete.

 
 
 
 
     
 


 
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