Deadline: May 8, 2015

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Deadline: May 8, 2015 Applications must be post-marked on or before deadline. Please be sure to complete the entire application. Incomplete applications will not be reviewed. Application is available online: njms.rutgers.edu/sysp

The Hispanic Center of Excellence Background The Hispanic Center of Excellence was established in 1991 to expand existing New Jersey Medical School programs with the ultimate goal of improving the health status of the Hispanic community. The goals of the Center are to foster recruitment of Latino medical students and faculty. Mission Statement The mission of the New Jersey Medical School, Hispanic Center of Excellence is to increase the number of Latino physicians by expanding the educational pipeline for students interested in medicine; to provide professional development opportunities to Latino faculty; to prepare medical students, faculty and residents in delivering culturally competent healthcare services to the community; and to increase the quality and quantity of research on health issues that impact Latinos and other underserved populations in our nation. Goals Foster the development and preparation of Latinos and disadvantaged individuals for careers in medicine. Provide students with research opportunities on health related issues affecting Latinos and other underserved communities. Introduce and expose students to medical health issues affecting disadvantaged communities. To develop curricular initiatives that promotes cultural competency skills of all medical students and faculty. To develop and increase the numbers of Latino faculty and other underrepresented groups at NJMS.

Summer Youth Scholars Program 2015 Program Application Hispanic Center of Excellence Summer Youth Scholars Program (SYSP) is an academic enrichment program for students interested in health careers/science. This program is for students who have completed the 10 th or 11 th grade. During this six week period, students are exposed to SAT preparation, anatomy & physiology instruction, participation in a research presentation, visits to colleges and exposure to medicine and biomedical research. Career counseling and skills development are also provided for program participants to ensure academic success. 2015 Program Date and Duration The SYSP Program is a six-week program that begins June 29, 2015 and ends August 7, 2015. The program is held daily from 9:00am until 3:00pm at New Jersey Medical School. Times may vary based on activities. Students must commit themselves to being here for those hours for the entire six-week program. Any student who appears to have difficulty adhering to the time commitment will be asked to leave the program. No exceptions, for any reason will be made. **Eligibility** Applicants should be completing the, 10th or 11 th grade in June 2015. Graduating seniors are not eligible. Applicants should have a grade point average of 3.0 or better and must have taken at least one course in the sciences. A student must be a U.S. citizen or permanent resident. All student participants will be required to release their SAT scores to the Office for Diversity and Community Engagement.

Application Procedure/Checklist Applicants must submit a completed formal application with all the required documents to be considered for acceptance. The application must include: two letters of recommendation-one must be from a science instructor; immunization record; attendance record; and a one to two page personal statement indicating future goals, reason for participating in the program and what you are planning to accomplish during this program. Transcripts must be in a sealed school envelope. Application Package Checklist (provided as a guide for students) Please be sure the following items have been completed and/or provided before mailing application: 1. Completed and signed application 2. Personal Statement 3. Immunization record 4. Attendance record 5. Two letters of recommendation; one must be from a science teacher 6. Official Transcripts from High School All documents must be received by the deadline, and sent to: Ms. Tanya Norment New Jersey Medical School The Office for Diversity and Community Service 185 South Orange Ave., MSB-B624 Newark, NJ 07101-1709 Phone: 973-972-3762/3763 Fax: 973-972-3768 Email: Norment@njms.rutgers.edu Following a pre-screening of the application, selected students will be interviewed before final acceptance into the program. Students selected to participate will be notified via email of acceptance into the program. Applications to the SYSP program will be reviewed on a rolling basis!(this means that applications may be reviewed as they are received and the spots may be filled before the deadline.

APPLICATION CAN BE PHOTOCOPIED PROGRAM APPLICATION Hispanic Center of Excellence SYSP 2015 Last Name First Name Middle Name Social Security # Mailing Address City State Zip Code Telephone No. and Area Code Date of Birth Place of Birth Email Address Ethnicity Race Gender Current Grade Level Total GPA Science GPA High School Currently Attending Address City State Zip Code Telephone No. What science courses have you taken and are you currently taking? Please list: Name and Telephone Number of Guidance/Academic Counselor: Email: Father s Name Occupation Annual Income Highest Level of Education High School College Graduate School Other (specify) Mother s Name Occupation Annual Income Highest Level of Education High School College Graduate School Other (specify) No. of Brothers Ages No. of Sisters Ages Person to be notified in case of emergency Relationship to applicant Telephone No. Please specify medical insurance, if any:

Please list extracurricular activities (include school, community, health research and/or church-related activities): Activity Dates From: To: Have you taken the SAT exam? Yes No Please record your test results. Test Date Verbal Math Critical Reading SAT s SAT s Writing Total Score Are you interested in a Health Sciences Career? Yes No Unsure If yes, which Health Sciences Career? If no, what career do you plan to pursue? How did you find out about this program? Parental Consent: As parent(s) guardian, I hereby give my (daughter/son) permission to participate in this program. I understand that (she/he) will register and be subjected to the rules and regulations of the Rutgers-New Jersey Medical School and the Office of Diversity and Community Engagement. I understand that should a health emergency arise, I will be notified. In the event I cannot be reached in an emergency, I authorize such medical treatment as deemed necessary by competent medical personnel. Signature of Parent/Guardian Date Signature of Student Date APPLICATION DEADLINE IS Friday, May 8, 2015

DETACH THIS APPLICATION AND SUBMIT WITH THE FOLLOWING MATERIALS: (Refer to Applicant Checklist) Official High School Transcripts Two Letters of Recommendation (one must be from a Science Instructor) Personal Statement (one or two pages) A copy of your current immunization record must be attached to the application Attendance Record Mail, Fax, or Email completed application to: Ms.Tanya Norment The Office for Diversity and Community Engagement New Jersey Medical School 185 South Orange Avenue, MSB, B624 Newark, New Jersey 07101-1709 TELEPHONE: 973-972-3762/3763 FAX: 973-972-3768 Email: normentm@njms.rutgers.edu GUIDELINES TO COMPLETE A SUCCESSFUL APPLICATION Below you will find some guidelines that will help you in completing your application. APPLICATION Make sure that you complete all sections of the application. Incomplete applications will not be considered for review. PERSONAL STATEMENT- (Please type or print) On a separate page please include information on personal attributes, future goals, reason for applying to this program, and what you plan to accomplish by participating. Personal statements must be written in English.

Personal Statement