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STUDENT INFORMATION (Please print): Last Name: First Name:Address: City, State, Postal CodeTelephone: Cell phone or other #:Major: E-Mail:Graduation Date (Month & Year): Major Advisor: COLLEGE ACTIVITIES (or attach detailed resume): Academic Year:Activities:Outside Work Each Year: (Employer, Location, Position Type, Hours)Dental Experience: (Employer, Location, Position Type, Hours)Other Experience: (Research, Travel, Summer Work, Clubs, etc.)Freshman Sophomore Junior  Senior -----OVER------ Course Numbers Semester/Year when classes were taken/Grade ______________________ _____________________________ ______________________ _____________________________ ______________________ _____________________________ GPA: Freshman:Sophomore:Junior:Senior:Semester 1 Semester 2 Cumulative GPA Cumulative Science GPA TOTAL Cumulative GPA to the Present Date: ADDITIONAL COMMENTS:  The following are sample questions that some universities may ask you to address when writing your letter. Please use as a guide. How long and under what circumstances have you known the applicant? What exceptional strengths does the applicant possess? What particular characteristics have you observed which you feel might hinder the applicants career in medicine? How well does the applicant get along with others? Is the applicant altruistic? How does the applicant handle stressful situations? How would you assess the applicants emotional maturity? Has the applicant demonstrated integrity and professionalism in their interactions with others? Of all the predental students you have known, would you rate the applicant in the upper 1%, 5%, 10%, 25% or lower on the basis of personal characteristics? 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