ࡱ> DFC ibjbj  Di $'t88888KKK,MK @KKK_88___K 88_K__x yU 0'__KKK_KKK'KKKKKKKKK :   WESTMONT COLLEGE Pre-Medical Committee and Composite Letter of Evaluation This form is to declare the members of your pre-medical committee, and to provide for the medical schools a composite recommendation summarizing the evaluations of each of the members. Please fill in the names and departments of the instructors you have chosen in the space below (needs to be typed), recognizing that you should have at least four additional members, and usually not more than six individuals listed. Also, two of these members should be from the Biology, Chemistry, Mathematics, or Physics Departments (additional members may be chosen from these departments if desired). One member should be from outside of the sciences and mathematics. An additional non-academic letter from a physician or health professions supervisor is strongly encouraged. Note that as the pre-medical advisor, Dr. Cantrell serves ex officio as the chair of the committee. I do hereby waive any rights of access that I may possess under any federal or state law to any letter of evaluation that is supplied by any of the faculty or staff of app, and is contained in my student records as maintained by either app or any other institution to which such a letter may be sent at my request. Applicant ______________________________________________________________________ Signature Date Committee Member Departmental Affiliation (& college if not app) Kristi Cantrell Chemistry - Chair of Committee WESTMONT COLLEGE Pre-Medical Committee and Composite Letter of Evaluation I do hereby waive any rights of access that I may possess under any federal or state law to any letter of evaluation that is supplied by any of the faculty or staff of app, and is contained in my student records as maintained by either app or any other institution to which such a letter may be sent at my request. 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