Apply Now (Externship) Mary Ann Lunsford Student Externship Application Step 1 of 3 33% Please provide the following information no later than March 15. Externs will be selected by the committee and will be notified by the end of March. Applications may be submitted online. Two letters of recommendations must be received by deadline via email to [email protected] or by surface mail. Along with your application, please ensure to email a copy of your transcript and CV/Resume to [email protected]Name* First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Will this also be your mailing address?* Yes No Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please include area codePlease specify your gender:* Female Male Other Date of Birth* MM slash DD slash YYYY What is your citizenship? (Must be able to work in the U.S.)* I am a US citizen I am a US legal alien EducationTo the best of your abilities, please fill out all your education information.What is your current college classification?* Sophomore Junior What are your cumulative college hours?*What is your current overall GPA?*Please enter a number from 3.6 to 4.0.College Major:* College Degree:* Please list all high schools / colleges attended to date:*Press the "+" button to add more listings.School / LocationFromToDegree HeadshotAccepted file types: jpg, gif, png, Max. file size: 1 MB. I certify that the information provided by me in this application is complete and correct to the best of my knowledge. I understand that I am responsible for having two letters of recommendation forwarded to Dr. Smalling and emailed to [email protected] no later than March 15th.* Agree Disagree Applicant Digital Signature Verification*Type your full name to certify that you agree with the above statement. We are unable to accept your application right now. This application and all other correspondence/inquiries should be directed to the following: Richard W. Smalling, M.D., Ph.D. c/o Araceli Rosas University of Texas- Houston Medical School Division of Cardiology 6431 Fannin, MSB 1.246 Houston, TX 77030 Email: [email protected] Phone: 713-500-6559 or Fax: 713-500-6560 NameThis field is for validation purposes and should be left unchanged.