Please complete this application and click the "Submit" button at the bottom of the page.
If you have any questions, please contact Ms. Filiz Aydin, CORE Administrator at 330-971-7439 or aydin@ohio.edu.
Online Application
First Name:
*
Middle Initial:
*
Last Name:
*
Gender:
Female
Male
Address:
*
City:
*
State:
Zipcode:
*
Email:
*
Mobile Number:
*
Hometown:
*
Please check the status for the requested rotation dates (not your current status):
MS III
MS IV
Resident PGY
What specialty area(s) are you considering for residency?
*
Medical School Information
Medical School:
Other School:
(not on list)
City:
*
State:
School Scheduling
Contact Person:
*
Contact Person
Email Address:
*
Contact Person
Phone Number:
*
Requested Rotation Information
Preference #1:
Start Date:
*
End Date:
*
Will this rotation be a Residency Audition Rotation?
Yes
No
Is Student Housing needed for this rotation, if available?
Yes
No
Preference #2:
Start Date:
End Date:
Will this rotation be a Residency Audition Rotation?
Yes
No
Is Student Housing needed for this rotation, if available?
Yes
No
Preference #3:
Start Date:
End Date:
Will this rotation be a Residency Audition Rotation?
Yes
No
Is Student Housing needed for this rotation, if available?
Yes
No
Preference #4:
Start Date:
End Date:
Will this rotation be a Residency Audition Rotation?
Yes
No
Is Student Housing needed for this rotation, if available?
Medical Students
