Junior Medicine Honor Society Application

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Name *

First

Last

Name position? be

Email *

Phone Number *

Home Address *

Current Grade *

High School Name *

GPA *

Please enter your GPA from your most recent report card. If you are selected as a semifinalist, you will be requested to submit an official transcript or report card.

Which areas of medicine are you interested in? *

Medicine (Doctors, Dentists, Psychiatrists)
Healthcare (Nurses, Physical Therapists, Diagnostic/Rad Technologists, Nutritionists, Genetic Counselors, Pharmacists, Physician Assistants, etc.)
Biomedical Engineering
Biomedical Research
Healthcare Policy, Administration, or Public Health
Mental Health, Psychology, Psychiatry

Name of Recommender *

First

Last

We require a recommendation from a teacher, employer, or mentor. Please note that the recommender must have a Master’s degree or five years of experience in a medical or health career.

Recommender's Email Address *

Membership Fee Waiver Approval or Discount Code

The annual membership fee is $25. Should you wish to apply for a need-based fee waiver, please contact medhonor@nationalscholar.com. If you have already been approved for a fee waiver or if you have been given a discount code, please enter it here.

Would you like to be considered for a leadership position? *

Acknowledgements *

I understand that if I am selected as a semifinalist, I will be required to submit an official transcript or report card to verify my GPA and good academic standing.
I understand that I will also be required to submit a resume listing my extracurricular activities and awards.
I understand that failing marks or grades below 70 may result in probation or even removal from the society.
I understand that academic dishonesty or other failures to uphold our standards of honesty, courtesy, respect for others, and decency may results in removal from the society.

Please check to acknowledge each statement.

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