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Liaison International

Other Information

Language Proficiency

Select your native language (the language of your birth). If you speak additional languages, click Add Another Language. Then, select the language(s) and the level of your proficiency in each.

Military Status

If you have US military experience, select your anticipated status at the time of enrollment from the drop-down. Select Not a member of the military if this does not apply.

If a member of the military, select your branch of the Armed Forces from the drop-down, and indicate the dates of service.

Military Discharge

Select whether you were honorably discharged from the military. If you select No, indicate why you were not honorably discharged.

Felony and Misdemeanor Convictions

Indicate whether you've ever been convicted of a misdemeanor or felony. Failure to disclose and provide accurate information about prior convictions may have serious consequences, such as annulment of acceptance offers, program dismissal, or other sanctions. 

Be aware of the potential impact for program acceptance. Contact the programs you wish to apply to for advice if you have a felony conviction or a criminal record. If you are uncertain of the status of a charge versus a conviction on your record, or if you are uncertain as to whether your offense was an infraction, misdemeanor, or a felony, contact the city, county, or state jurisdiction where the incident occurred.

If you are convicted of a misdemeanor or felony prior to admission and/or matriculation, it is your responsibility to immediately inform your program(s).

Academic Infraction

Indicate whether you have ever been disciplined or placed on academic probation while attending an academic institution. If yes, enter an explanation in the spaces provided.

Denied Readmission

Indicate whether you have ever been denied readmission to an academic program due to academic conduct or performance. If yes, enter an explanation in the space provided.

License Infraction

Indicate whether you have ever had any certification, registration, license, or clinical privileges revoked, suspended, or in any way restricted by an institution, state, or locality. If yes, enter an explanation in the spaces provided. 

Background Information

Programs fully recognize the importance of diversity in their student body and in the work force. Accordingly, programs strongly encourage applications from persons from all socioeconomic, racial, ethnic, religious, and educational backgrounds and persons from groups underrepresented in the industry. Please select any and all of the options in this section which you feel best apply to you. Please note that NEOMED uses this section for statistical purposes only and it in no way affects your application or financial aid eligibility.  

Social Security Number

Enter your social security number. This field is optional, but some programs may require it for their application, or for institutional or federal financial aid forms. Contact your programs directly to determine if they require you to enter your social security number. 

Previous Attendance at a Medical School or Health Profession Program

Select your answers to any additional questions. Answering these questions helps programs gather information to develop future recruitment strategies.

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