example: 01/01/2000

Are you a Kansas Resident?*

Please select one:

Does one of the following Kansas Ties apply to you?*

I currently reside and work in Kansas.
I have a parent currently residing in Kansas.
I am or will be a graduate of a Kansas high school.
I am or will be a graduate of a Kansas four-year college.
I have a parent who is a graduate of the KU School of Medicine
I have a parent who is a member of the faculty of the KU School of Medicine.

Please select one: