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<p>Spirit of EAGLES American Indian/Alaska Native Leadership Initiative on Cancer Student Application for MCAT/GRE Exam Preparation Workshop January 9-11, 2015</p><p>A Funding Source for: Undergraduate, Post Baccalaureate, Graduate, and Medical School/Medical Preparatory Conference Assistance Journal Publication Assistance Medical School Application Assistance U54-CA153605 Spirit of EAGLES American Indian/Alaska Native Leadership Initiative on Cancer American Indian and Alaska Native (AI/AN) populations have very high incidence rates for specific cancer sites and poor survival rates for most cancers. This AI/AN Leadership Initiative on Cancer addresses comprehensive tribal cancer control through partnerships with The Network for Cancer Control Research among AI/AN populations, tribes, multiple cancer centers, and non- profit organizations on health issues. This Initiative will assist tribes 1) to increase community awareness and understanding of cancer, 2) to provide training in cancer control research for AI/AN researchers, and 3) to improve native community channels to the National Cancer Institute (NCI) so that research can be specifically focused on issues that affect Native people.</p><p>MCAT/GRE Preparation Workshop The Spirit of Eagles has recognized the importance of providing assistance to students preparing to take the very challenging and expensive MCAT and GRE Exams. We are offering a unique 2 day workshop for Pre-Medical and/or Pre-PhD Native American students who are planning to take the MCAT and/or the GRE Exams within the next year. This year our workshop will be held January 9-11, 2015 in Minneapolis, MN. Our featured speaker will be Jay Rosner, Executive Director of the Princeton Review Foundation. Jay has extensive experience in providing exam preparation presentations for MCAT, GRE, LSAT, and GMAT Exams. Jay works regularly with organizations - such as Graduate Horizons, College Horizons, and the Student National Medical Association – and has provided guidance to many students through our Spirit of EAGLES workshops. PLEASE NOTE: As the MCAT format is changing, only the new format (MCAT2015) will be addressed. Since no one has seen it yet (first test to be administered in February 2015), strategy recommendations will be extrapolated from the information that MCAS has so far distributed. The cost of attendance is free. Exam preparation books will be provided to you at no cost. The Spirit of EAGLES will provide up to $500.00 for airfare/transportation costs and you will make travel arrangements through our travel agency. Meals and ground transportation will also be provided. </p><p>This application must be completed and returned no later than 9am CDT on Monday, December 15, 2014 to Marcy Averill, [email protected].</p><p>Please fill in (type or print) answers to all of the questions. Use N/A if not applicable to you. General Information:</p><p>Name: (Last) (First) (M.I.) SSN:* Date of Birth: *Social Security Number is required mm dd yyyy</p><p>Age: Sex: Female Male Other</p><p>Tribal Affiliation (if applicable): </p><p>Best telephone number to reach you at: </p><p>E-mail: </p><p>Home Address:</p><p>Street</p><p>City State Zip Code</p><p>College Address:</p><p>Street</p><p>City State Zip Code</p><p>College and Exam Information:</p><p>College Attending: </p><p>Year in College: </p><p>Med Prep Program College Program Medical School Graduate School Other List: </p><p>Area(s) of Interest: </p><p>If you have previously taken the MCAT and/or GRE, please indicate your score(s) and the year the exam was taken: MCAT: Year: GRE: Year: If you have NOT, previously taken the MCAT and/or GRE, please indicate your approximate SAT and/or ACT score(s) and the year the exam was taken: SAT: Year: ACT: Year: Please note that the scores above are for informational purposes only – they will NOT affect your acceptance into this program. need MCAT Preparation need GRE Preparation Date planned for MCAT/GRE: </p><p>Have you attended a Spirit of EAGLES MCAT/GRE Preparation Workshop before? Yes No </p><p>Reasons why you feel you would be a good candidate to be selected for this opportunity: </p><p>Please provide the following Attachments/Documents: a) Copy of your latest official transcript listing current overall GPA b) Letter of Support from academic personnel</p><p>If you have questions/concerns, please contact: Marcy Averill Operations Director for Spirit of EAGLES American Indian/Alaska Native Initiative on Cancer Mayo Clinic (507)266-3064 [email protected] Workshop Scholarship Agreement:</p><p>1. Participants will attend all scheduled workshop activities.</p><p>2. Participants will limit use of cellphones and other technology during sessions to emergencies only.</p><p>3. Participants will report back to Spirit of EAGLES upon completion of the MCAT/GRE Exam with test outcomes.</p><p>4. Participants will provide updates to contact information and/or stay in touch with Spirit of EAGLES at least until accepted into Medical School or Graduate School. 5. Spirit of EAGLES will provide an introduction to exam preparation training via qualified and experienced trainer.</p><p>6. Spirit of EAGLES will provide exam preparation books at no cost.</p><p>7. Spirit of EAGLES will provide up to $500 for justified airfare / transportation costs.</p><p>8. Spirit of EAGLES will provide lodging, meals, and ground transportation.</p><p>9. Spirit of EAGLES will provide opportunities to stay involved with the program and to apply for ongoing/future support.</p><p>Please indicate agreement, provide signature, and date. I agree to follow the scholarship guidelines (above) if I am selected to receive a MCAT/GRE Prep Workshop scholarship. I hereby grant Mayo Clinic Spirit of EAGLES permission to interview me and/or use my likeness in photograph(s)/video in any and all of its publications and in any and all other media, whether now know or hereafter existing, controlled by Spirit of EAGLES, in perpetuity, and for other use by Mayo Clinic Spirit of EAGLES. I will make no monetary or other claim against Mayo Clinic Spirit of EAGLES for the use of the interview and/or the photograph(s)/video.</p><p>Signature: Date: </p>
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