PHC Registration Form
PHC Registration Form
Entry Year (1st semester at ODU)
*
*
Freshman
Sophomore
Junior
Transfer
Post-Baccalaureate
Name
Name
*
First
Last
UIN (ex. 01234267)
*
ODU Email
*
What's your major?
Are you of Hispanic or Latino descent?
Are you of Hispanic or Latino descent?
Yes
No
Select one or more of the following races:
Select one or more of the following races:
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
What kind of professional schools are you interested in? Select all that apply.
*
What kind of professional schools are you interested in? Select all that apply.
Medicine (DO)
Medicine (MD)
Pharmacy
Dentistry
Optometry
Physician Assistant (PA)
Veterinary Medicine
Occupational Therapy
Athletic Training
Physical Therapy
Other
Other
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What is "seven hundred" as a number?