Office of Diversity & Minority Affairs (ODAMA)
Open House for Pre-health/Pre-med Advisors & Underrepresented Students in Medicine

Your Information:   Program(s) of Interest:
Last Name:     Jefferson Medical College (JMC)
First Name:   Jefferson School of Health Professions (JSHP)
Email:   Jefferson School of Nursing (JSN)
Address:   Jefferson School of Pharmacy (JSP)
 Jefferson School of Population Health (JSPH)
City:   Jefferson College of Graduate Studies (JCGS)
State:   
Zip Code: I am a: Student     Advisor
Phone:  

If you experience problems sending this form, please print and submit to:

Luz M. Ortiz, M.A.
Assistant Dean
Jefferson Medical College
Office of Diversity & Minority Affairs
1020 Locust Street, Suite 163, JAH
Philadelphia, PA 19107
(215) 503-4795
(215) 503-4095 fax


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