College of Medicine: Scholarship Survey If you have questions, please contact Ann Koralewski in the Office of Development & Alumni Affairs at aooton@ufl.edu or 352.627.7754. Bio InformationName(Required) First Last Preferred Name Preferred First Name (if different than above) UF ID Number(Required) University of Florida ID NumberEmail(Required) Enter Email Confirm Email Which pronouns do you prefer?(Required) She/her He/him They/them What is your current school classification?(Required) First-year Medical Student Second-year Medical Student Third-year Medical Student Fourth-year Medical Student First-year Physician Assistant Student Second-year Physician Assistant Student What location do you consider your hometown?(Required) Prior Education InformationAt what institution did you earn your undergraduate degree?(Required) What was your field of undergraduate study?(Required) Tell Us About YourselfI decided to attend the University of Florida College of Medicine because _______.So far, what is your fondest memory of medical/PA school?First year students can skip this question.I chose to pursue becoming a physician/physician assistant because ____________.Required for first year students.What specialty do you plan to pursue after graduation? Your Photo Upload(Required) Drop files here or Select files Accepted file types: jpg, tiff, png, pdf, Max. file size: 125 MB. Please upload a clear, recent photo showing your face, which will be included with the Thank You note to your donor.Thanking Your Scholarship DonorPlease tell us what your scholarship means to you (175 characters max). Example: "Because of this scholarship, ____________."(Required)Please give a brief thank you to your COM scholarship donor: (415 characters max)(Required)Multi-purpose opt-out Opt-out If you do not wish for your responses to be shared in other ways, such as newsletters, magazines, social media, web, or other communications pieces, check this box to opt-out. Note: Your responses will still be shared in a thank you card to your scholarship donor(s).PhoneThis field is for validation purposes and should be left unchanged.