| INSTRUCTIONS TO THE APPLICANT | |||
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Rev. May 2024
Application for ResidencyThis application for residency at All Saints General Hospital utilizes the Electronic Residency Application Service created by the Association of American Medical Colleges. By completing this application, you give permission for the AAMC to transmit the personal information described on page 4 of this form.
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| . Page 1 of 4 |
| I. BIOGRAPHICAL INFORMATION | |||
| 1. Full Name: Derrick Cohen | 2. Date of Birth: 27/NOV/1993 | 3. Sex: Male | 4. Gender: Male |
| 5. Height: 6'2" | 6. Weight: 166 lbs | 7. Phone Number: 2149011 | |
| 8. Home Address: 1449 Market Street, Los Santos, San Andreas 18125 | 9. Are you a citizen of the United States? YES NO |
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| 10. Do you possess a San Andreas State Driver's License? YES NO |
11. Have you ever received a civil infraction? YES NO[/color] |
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| 12. Have you ever been convicted of a misdemeanor or felony? YES NO |
13. If you answered yes to 11 or 12, explain here: N/A[/color] |
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| 14. Have you received the vaccines for influenza, Hepatitis B, MMR, Varicella, and Tdap? YES NO |
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| 15. If you answered NO to 14, will you receive those vaccines before joining our staff? YES NO N/A, I ALREADY HAVE THEM |
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| . Page 2 of 4 |
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| II. EDUCATION | |||
| 1. Undergraduate Institution: University of Los Santos | 2. Degree Received: BS | 3. Cumulative GPA: 3.85 | |
| 4. Major(s): Molecular and Cell Biology | 5. Minor(s): Public Health | 6. Medical College Admission Test (MCAT) Score: 520 (472-528) | |
| 7. Medical School: Baylor College of Medicine | 8. Degree Sought: MD | 9. Date (to be) Received: JUN/2021 | |
| 10. United States Medical Licensing Exam (USMLE) Total Score: 250 (150-300) | |||
| 11. Other Postgraduate Education: Master of Public Health (M.P.H.) - Baylor College of Medicine, 2023 | |||
| . Page 3 of 4 |
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| III. APPLICANT STATEMENTS | |||
| 1. Explain why you wish to enter All Saints General Hospital's Residency Program: After pursuing my aforementioned degrees and completing an extensive educational and professional record, I've moved from my residence in Montgomery, Los Santos, to Market, Los Santos, to start working under a residency program at a large and prestigious medical facility such as All Saints General Hospital. Currently, I am doing a couple of side jobs, including taxi services and bartending, to sustain myself financially, but I believe it's time to finally put what I've learned over the past decade to use. My goal is not only to extend a helping hand to the community as a whole but also to ensure a fruitful career that will help me improve myself as a person. |
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| 2. Applicant Agreement: I, Derrick Cohen, certify under penalty of perjury that all the information I have given on this application is complete and correct. I understand my failure to provide complete, accurate, and truthful information on this application will be grounds for denial, dismissal after acceptance, and/or possible criminal charges. I agree to notify, in writing, All Saints General Hospital's leadership of any changes or updates to my application materials. I agree to allow the Association of American Medical Colleges (AAMC) to transmit my curriculum vitae, personal statement, medical school transcripts, letters of recommendation, Medical Student Performance Evaluation (MSPE), and confirmation of licensing examination score to All Saints General Hospital via the Electronic Residency Application Service (ERAS). Furthermore, by submitting this application, I hereby grant All Saints General Hospital permission to run a full investigation on me. |
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| . Page 4 of 4 |
| (( IV. OUT-OF-CHARACTER INFORMATION )) | |||
| 1. Timezone: GMT+ 2:00 | 2. LS-RP Forum Name: ihealyou | 3. Do you wish to join Mount Zonah on RageMP as well? NO If yes, character name: N/A |
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| 4. List all your character names and levels:
Character 1: Derrick Cohen (Level 2)
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5. Provide Copies of your unedited admin records: | ||
| 6. Are you currently in an official faction? YES NO
If yes, provide proof of double faction permission: Permission. |
7. Are you currently banned from any official factions? YES NO
If yes, explain here: N/A |
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| 8. List all official factions you have been in: |
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