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Other Information

Language Proficiency

Select your first 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 on 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 Performance or Conduct

Indicate if there has been a determination by any college, university, or school of: (1) unacceptable academic performance (academic probation, suspension, dismissal, etc.) or (2) student code of conduct violations. If you select Yes, enter a brief explanation in the field provided. Include 1) a brief description of the incident(s), 2) actions imposed by colleges, universities, or schools, 3) related dates, and, 4) a reflection on the incident and how the incident has impacted your life.

Adverse Action(s) in Professional Privileging/Licensing

Indicate whether you have ever had any certification, registration, license, or clinical privileges revoked, suspended, denied, or in any way restricted by an institution, state, or locality. If you select Yes, enter a brief explanation in the field provided. Include 1) a brief description of the situation, 2) adverse action imposed and the basis for each action, 3) related dates, and, 4) a reflection on the incident and how the incident has impacted your life.

Background Information

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

Low Income Levels Guidelines

If applicable, use the following chart to help you determine if you come from an economically disadvantaged background.

Size of Family*

Income Level**

















For each additional person, add:


The low income level is based on 200 percent of the U.S. Department of Health and Human Services poverty guidelines. It is used to determine what constitutes a low-income family for the purposes of the SDS and LDS programs.

* Size of family means the number of exemptions listed on the qualified income tax return forms. For example, a family size of 4 may include two parents and two dependents.

** Income Level refers to the adjusted gross income stated on the federal income tax return 1040.

Academic Information

Indicate whether you previously applied to any RFUMS programs, are a member of the RFUMS community, or if any members of your immediate family are members of the RFUMS community.

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