"JAMP exposed me to medical school curriculum and allowed me to network with various future physicians. Also, it exposed me to medical practice in many Texas cities and made me realize the diversity and opportunity available by practicing in Texas."

—Fernando Bolivar
JAMP Medical School student

Student Information Request Form

With few exceptions, state law gives you the right to request, receive, review and correct information about yourself collected on this form (See below).

The form below is to be completed by a student requesting information on JAMP.

All others should email their requests to jamp@utsystem.edu .

*Required Data cannot be left blank.

Date of Birth:

Gender:

Ethnic Origin:
This information is used for state and federal reporting purposes.

*First Name:
Middle Name:
*Last Name:
*Address:
*City:
*State:
*County:
*Zip Code:
Country:
Telephone:
*Email:

Name of High School:
Classification:

University applied or accepted to:
1st choice: Applied or Accepted:
2nd choice: Applied or Accepted:
3rd choice: Applied or Accepted:

ACT Score:
SAT Score:
You must take one of these tests to be eligible to apply to JAMP

Financial Aid:
Have you filed an FAFSA?

Right to Review and Correct Information

Under state law:

You are entitled to request to be informed about the information that the Joint Admission Medical Program (JAMP) collects about you, with some exceptions;
You are entitiled to receive and review the information in accordance with the Public Information Act;
You are entitled to have JAMP correct any information about you that is incorrect.

UT System Privacy Policy