Summer Camp Application

Please complete the application form below in it's entirety. You will need to have your participation essay completed prior to submitting this application. You will attach it as part of your application.

Contact Information

First Name

Middle Name

Last Name

Email Address

Birthdate

Race

Gender

Mobile Phone Number

Would you like to receive text messages from TTUHSCEP?

Yes

No

Address Information

Mailing Address

Country

Street

City

Region

Postal Code

Parent Guardian Contact Information

First Name

Middle Name

Last Name

Email Address

Contact Number

Reference Information

Please enter information for a science teacher or school counselor who will submit a reference on your behalf.

First Name

Last Name

Contact Number

Email:

Academic Information

What is the name of the most recent school that you attended?

Current Grade Level:

Current GPA:

Sciences GPA:

Honors and Awards: (List any distinctions or honors you have received)

Extracurricular work or activities: (List any community service or any other leadership activities)

Have you taken the PSAT?

Yes

No

PSAT Composite Score:

Have you taken the SAT?

Yes

No

SAT Composite Score:

Please list any other camps or TTUHSCEP outreach programs that you were a participant? (Ex. Medventure for Your Future, D.R.E.A.M.S, Summer Medical Camp, or other types of camps?)

The following are the 2024 Texas Tech University Health Sciences Center Paul L. Foster School of Medicine Summer Camp Dates, please rank your preference in which you would like to attend:

June 17th - June 28th:

1st

2nd

June 17th - June 28th:

July 8th - July 19th:

1st

2nd

July 8th - July 19th:

Essay

Essay Instructions:
In a separate word document, with a minimum of 200 words, Please tell us why you are interested in the medical field and why Summer Camp would be beneficial to you.

Essay

Certification

By submitting this form, I hereby affirm that, to the best of my knowledge, all information furnished as part of my application is complete and accurate. If it becomes necessary for me to withdraw my application, I agree to notify the Admissions office so that I will not deprive another student of the opportunity to participate. I understand that if accepted in the Summer Camp program, that photographs will be taken for possible use on the website or for other promotional material. I give permission for the Office of Admissions to use these photographs for this and for promotion of its mission.

PLFSOM Summer Camp Application

Summer Camp Application

Academic Information