Wufoo

Name * First Last
Emory ID # *
Must be between 7 and 7 digits. Currently Used: 0 digits.
Email (Emory preferred) *

Please use non-Emory email if you will no longer have access to an Emory email within the next few months, though Emory email is preferred if you will retain access to that e-address.
Email (Alternate email)

All seniors and alumni should include an alternate email address to avoid missing important information from the PHMO
Current Class Standing *
To which programs were you planning to apply? *
Allopathic Medicine (MD) Osteopathic Medicine (DO) Dentistry (DDS) Combined MD/PhD Optometry (OD) Podiatry (DPM)
Why are you withdrawing your Composite Letter application? *
Do you plan to apply to medical/dental/optometry/podiatry school this upcoming cycle (opening summer 2018) WITHOUT a Composite Letter? *
Yes No Not Sure
If you are not applying this upcoming cycle (opening summer 2018), do you plan to apply to medical/dental/optomtery/podiatry school in the future? *
Yes No Not Sure
If you responded "yes" above, when you do plan to apply?
2020 Admission Cycle (opening summer 2019) 2021 Admission Cycle (opening summer 2020) I'm not sure NA - I no longer plan to apply to medical/dental/optometry/podiatry school
By submitting this withdrawal form, you will no longer be eligible for a 2018 Composite Letter. If you are eligible for a Composite Letter in future years, you must comply with all deadlines/policies and procedures of that application cycle, including submission of new application materials.
Do Not Fill This Out

Wufoo

By submitting this withdrawal form, you will no longer be eligible for a 2018 Composite Letter. If you are eligible for a Composite Letter in future years, you must comply with all deadlines/policies and procedures of that application cycle, including submission of new application materials.