Senior Students with Junior Rotations to complete after May 19th, 2023

Junior Lottery – Spring 2023

Please return this form to the Division of Clinical Education, Room 114K, 2900 Queen Lane via a scanned pdf to: clinicaleducation@drexel.edu, NO LATER THAN Noon on Monday, January 2, 2023.

DO NOT PROVIDE INFORMATION RELATED TO A DISABILITY ON THIS FORM.

If you have an accommodation from the Drexel Office of Disability Services, please send a copy of your AVL to the Office of Student Affairs by January 2nd. You do need a new AVL for the 2023-2024 academic year.

This form is only for students with twenty (20) or more clerkship weeks to complete in the 3rd year of the curriculum.

DATE:	PHONE #:
NAME:	E-MAIL:
SIGNATURE:
Are you a parent? Yes:                         No:	Do you have a current Accommodation Verification Letter on file related to site placement with Student Affairs from the Drexel Office of Disability Services? Yes:                         No:

Entering 4^th year with some 3^rd year work to complete	XXX
Please clearly list the clerkship(s) you need to complete along with how many weeks so that DOCSS may be programmed to allow you to rank preferences. Please note that although you will rank site preferences in DOCSS, you will be scheduled to maximize your progression through the curriculum. This may mean rescheduling the order of clerkships closer to the start date of rotations.

rev.11/28/2022