Brandon Buras Memorial Scholarship

BRANDON BURAS MEMORIAL SCHOLARSHIP

NOTE! The deadline for submitting this application is Friday September 25, 2015. Please submit along a current (unofficial) transcript, MCAT score (if you have it), and one short letter of recommendation (recommendation letter is waived in fall 2015).

Completed applications should be emailed to the pre-medical advisor (Dr. Stiller).

Name Overall GPA

Address Hours Completed

Email Intended Graduation Date Home Phone W number Cell Phone Social Security #

Age Major Minor

Academic Senior MCAT score Rank/ Classification

Are you from Tangipahoa, Livingston, St. Helena, or Washington parish? (Please delete one) Yes No

Name of the accredited medical school(s) that you have been applying to.

Version: February 2015