2025 PrIMES Interest Sign-up Form

The PrIMES Mentorship Program is a pipeline initiative designed for underrepresented minority college students interested in pursuing a medical education. We primarily recruit college freshmen, sophomores, and occasionally juniors from underrepresented racial and ethnic backgrounds.
Please complete the following interest form, and we will reach out to you when applications for the upcoming cycle open!
1.First Name(Required.)
2.Last Name
3.Email Address:(Required.)
4.What school do you currently attend?(Required.)
5.Where are you currently located (City, State)?(Required.)
6.What year are you in school?(Required.)
7.How did you hear about our program?
8.Do you identify as underrepresented in medicine? ( The AAMC definition of Underrepresented in Medicine is: “Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” This AAMC definition allows for a variety of ways to conceptualize URiM, depending on whether (for example) one is looking at the national perspective, regional perspective, or local perspective.)
9.Do you have stable internet? Please note, PrIMES Mentorship is a virtual platform and program
10.Are you able to commit to at least two hours per week to meet with your mentor and participate in PrIMES' online pre-med events?
11.What is your reasoning for joining PrIMES, and what do you hope to gain from the program?