Dr. Louis Sklarow Award Application

This is where information will go about the Sklarow award. Date application opens, date applications are due, info about the award, etc.

Please complete the application below to be considered for the Dr. Louis Sklarow Award.

"*" indicates required fields

Name*
Home Address*

Undergraduate Record:

Summer Experience:

Extracurricular Activities:
Research Experience:
Publications:
Honors and/or Awards:

Career Goals:

Please indicate your plans for the future:

Medical School Record:

Please have Academic Transcripts sent to:
Dr. David Milling
Senior Associate Dean for Student & Academic Affairs
Jacob School of Medicine & Biosciences University at Buffalo
955 Main Street, Room 1200
Buffalo, NY 14203-1121
The deadline to submit academic records is XXX, 2023

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Max. file size: 50 MB.