Saturday Academy Application Main MenuClose Main MenuClose Admissions About our School Programs Electives Students Residents Faculty Alumni & Friends News Events Research Directories Giving Tour Report Mistreatment Doctor of Medicine Programs B.A. / M.D. Program M.D. Program – Kansas City M.D. Program – St. Joseph Graduate Programs Master of Science in Anesthesia Master of Science in Bioinformatics Master of Medical Science Physician Assistant Master of Health Professions Education Graduate Certificate in Clinical Research Graduate Certificate in Health Professions Education Interdisciplinary PhD Program Middle/High School Programs Saturday Academy Summer Scholars Program Admissions Events Resources High School Diversity programs Office of Student Affairs Financial Wellness Office of Student Financial Aid & Scholarships About UMKC Office of Admissions, M1-103 UMKC School of Medicine 2411 Holmes Kansas City, MO 64108 Phone: 816-235-1870 Email: medicine@umkc.edu Saturday Academy Application 2020PERSONAL INFORMATION: First Name:* Last Name:* Middle Name/Initial: Address: Street Address City State / Province / Region Postal / Zip Code Telephone:* Area Code - Phone Number E-mail:* Date of birth (mm/dd/yy}: Gender:MaleFemaleNon-binary or Gender non-conforming Are you Hispanic/Latino?YesNoWhich of the following do you consider to be your racial background? Please check all races that apply: Race OptionsAmerican Indian/Alaskan NativeAfrican American/BlackAsian (underrepresented)Asian (includes Chinese, Filipino, Japanese, Korean, Asian Indian or Thai)White/CaucasianNative Hawaiian or Other Pacific IslanderNot SpecifiedEDUCATION INFORMATION: Name of school: Grade: Is student taking, or previously taken: Biology, Chemistry, Algebra?YesNo If yes, please specifyPARENT/GUARDIAN INFORMATION AND CONSENT: Parent/Guardian Name(s): Address (if different from yours) Per the above, are you the _____ (please select one)ParentGuardian Parent/Guardian E-mail: Parent/Guardian telephone:* Area Code - Phone Number Where does your Parent or Guardian work?SUPPLEMENTAL QUESTIONS: Why are you interested in participating in Saturday Academy? What do you hope to get from the program? Will you participate in tutoring from 9:00 a.m. to 10:00 a.m.?YesNo What health care career field are you most interested in exploring?Select MedicineNursingPharmacyDentistryOtherUndecidedRank order which health care career field you are most interested in exploring. (1 indicates your greatest interest / 5 indicates the least interest) Medicine: Nursing: Pharmacy: Dentistry: Other:SubmitReset