University of Southern California USC Med-COR

Student Interest Card

If you are interested in joining the USC Med-COR program, please fill out the form below with your contact information, and a member of our staff will get in touch with you. You may also download and print the Microsoft Word version of this form and mail it to:

USC Med-COR
1000 S. Fremont Avenue. 
Building A-10, 4th Floor Suite 10459, Unit 73
Alhambra,  CA  91803
626-457-6684

 



Date:
First Name:
Last Name:
Email:
School:
Grade:
Address:
City:
State:
Zip:
Phone:
Career Interest:
If you are in middle school,
write the name of the high school
you plan to attend: