Verification Form for the 3+1 Program

The applicant is responsible for submitting this form to the OSU-CHS College of Medicine Admissions Office at osucomadmissions@okstate.edu by October 15.

Section 1: To be completed by the 3+1 applicant in their fall semester of their junior year.

Institution *

Student Name *

Anticipated Start Date *

Primary Major *

Planned MCAT Date *

School Email *

Alternate Email

Student Signature *

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Date *

Phone *

Please ensure the correct email address is provided, as this form will be emailed to your academic advisor to finalize the next steps.

Academic Advisor Email *

Notes for Academic Advisor (optional)

After you have completed this section, scroll down to the bottom of the form and click submit to send to your academic advisor.

Section 2: To be completed by the applicant’s primary academic advisor or Pre-Health Advisor.

Staff Name *

Phone *

Title *

Email *

I verify that the student is currently meeting the following academic requirements for the 3+1 Program, as outlined in the University Catalog and the OSU-CHS College of Medicine’s eligibility requirements for the student's major.

Their primary major is an approved major for the 3+1 Program.

Is enrolled as a full-time student.

The student has a cumulative 3.5 Grade Point Average (GPA) and a 3.5 science GPA.

Has previously earned no more than 29 degree-applicable college-level coursework towards their major.
(Concurrent/dual enrollment and AP credits DO count towards this credit limitation).

Completed no more than five (5) semesters in college at the time of application.
(Concurrent/dual enrollment, AP credits, and summer coursework DO NOT count towards this semester’s limitation.)

Completed 60 or more credit hours toward a bachelor’s degree in the approved major.

Staff Signature *

Date *

Questions? Contact the OSU-CHS College of Medicine Admissions Office at osucomadmissions@okstate.edu

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