Personal Information

Contact Information

Legal Name:

Enter your first, middle, and last names. You will also enter any salutations or prefixes associated with your name.

Other Names:

If you prefer to be addressed by a different name other than your legal name, you will indicate that information in this section.
If there are any other names listed on your academic records than what you have already entered, you must indicate each additional name then click the button. Examples include maiden names or hyphenated last names.

E-mail/Phone:

Indicate your e-mail address. If you need to change your email address, do so through the [My Account] link in the upper right-hand corner of the application.

Provide the cell phone number where JAMP and/or medical school admissions officers can contact you.
If you do not have a cell phone, you will answer “No” to the question “Do you have a cell phone?”

You will also provide your work phone number – if applicable.

Mailing Address: Enter all fields of the Mailing Address section.

Address 1 – Enter your current mailing address. JAMP will use this address to send you any correspondence.
Address 2 – If needed, enter an apartment number or additional address information in this field. If not, leave this field blank.
City – Type the name of your city.
Country – Select your country from the pull-down menu.
State – Select your state from the pull-down menu.
County – Select the US County of your mailing address from the drop-down menu – if applicable.
Zip Code or Postal Code – Enter your zip or postal code.
Phone number – Provide the phone number where JAMP and/or admissions officers can contact you.

Permanent Address: Enter all fields of the Permanent Address section.

Enter your Permanent Address information if different from your Mailing Address.
If your Permanent Address is the same as your Mailing Address, answer “Yes” to the question “Is your Mailing Address also your Permanent Address?” and the information will pre-populate from what you entered under Mailing Address.

Demographic Information

Birth Information: Enter the following information.

Date of Birth – Enter your date of birth (mm/dd/yyyy)
City – Enter the city where you were born.
Country – Select the country in which you were born from the drop-down menu.
State/Possession/Canadian Province – Select the state, possession, or province where you were born.
County – Select the US County in which you were born from the drop-down menu – if applicable.

Hometown: The following questions refer to what you consider your “hometown”

City – Enter the city name of your hometown.
Country – Select the country from the drop-down menu.
State/Possession/Canadian Province – Select the state, possession, or province from the
drop-down menu.
County – Select the US County of your hometown from the drop-down menu – if applicable.
Approximate population – Select the approximate population range from the drop-down
menu.
Describe the area – Select: Rural, Urban, Inner City, Suburban, Military or Government
Installation or Other. (Definitions will be provided)
Primary language spoken at home – Select the primary language spoken from the drop-down
menu

Sex: Select one of the options shown.

Gender Identity: Select one of the options shown.

Pronouns: Select one of the options shown.

Ethnicity: Indicate whether you are:

Hispanic or Latino - Select one of the groups that you consider to be your ethnic background.
Not Hispanic or Latino

Race: Select one or more of the displayed racial categories that best describe you.

Race or Ethnic Group Descriptions: Ethnicity and Race questions are asked for federal and/or state reporting purposes. These questions are voluntary and applications will not be at a disadvantage in the admissions process if they are not completed.

Hispanic or Latino	A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Black/African American	A person having origins in any of the black racial groups of Africa.
Asian	A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
American Indian or Alaskan Native	A person having origins in any of the original peoples of North and South America (including Central America) who maintains cultural identification through tribal affiliation or community attachment. Applicants may be expected to provide official documentation/certification of active affiliation with a recognized tribe or reservation community.
White/Caucasian	A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Native Hawaiian or Other Pacific Islander	A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Socioeconomic Information

The questions in this section ask:

Are you a member of the first generation in your family to apply to, attend, or graduate from
an undergraduate program? (i.e. are you the first in your immediate family to go to college?)
Are you a member of the first generation in your family to apply to, attend, or graduate from a graduate or professional program?
Are you a parent or guardian of dependent children?
What do you consider your primary language?
Are you bilingual or multilingual?

Household Info from Birth to Age 18: You will also be asked several questions that pertain to the
household in which you were raised or spent the majority of your life from birth to age 18.

If you moved frequently during this time period, enter the information for the location you spent the majority of your childhood.

Socioeconomically Disadvantaged: There is a required question that asks the applicant to describe why they believe they are socioeconomically disadvantaged.

You have 600 characters to address this question.
Please provide any insight into your situation that was not previously addressed in your
application.

Military Service

You will answer questions concerning whether you have served in the United States military.

Family

Parent/Legal Guardians: An applicant will be able to enter up to six parent/legal guardians as well as information regarding siblings.

The section will ask questions including but not limited to the following data:

Relationship: Biological parent, adoptive parent, other legal guardian, grandparent, sibling.
Address
Education/occupation information
Is this a legal guardian or did you live with this person for three years while in high school?

Significant Person: An applicant will be able to enter up to six entries in this section including the following data:

Relationship: Biological parent, adoptive parent, other legal guardian, grandparent, sibling.
Residency information
Education/occupation information.

Financial Information

You will enter the percentage of your college expenses provided by family, spouse, academic scholarships, financial need-based scholarships, loans, employment, or other sources. The total percentage must add up to 100%.

Felonies and Misdemeanors

Have you ever been arrested or charged with any violation of the law regardless of outcome?

Unless the offense involved alcohol or drugs, you may exclude: 1) traffic tickets; and, 2) violations with fines of $250 or less.
Serious traffic offenses such as reckless driving, driving under the influence of alcohol and/or drugs, hit and run, evading a peace officer, failure to appear, driving while the license is suspended or revoked MUST be reported.
- This list is not all-inclusive. If in doubt as to whether an offense should be disclosed, it is better to disclose the offense on the application.
Matters in which you were diverted, deferred, pardoned, or pled nolo contendere MUST be disclosed.
If you are in doubt as to how to respond to the questions, full and honest disclosure is highly recommended.
If you answer “Yes” to any question in this section, you are required to submit records and a statement.