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Liaison

Other Information

Language Proficiency

Select your first language (the language of your birth). If you speak additional languages, select Yes. Then, select the language(s) and the level of your proficiency in each.

Background Information

Indicate if you received a Pell Grant as an undergraduate student.

Indicate if you are a first-generation student (i.e., neither parent/legal guardian attended college).

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 Deferment

Indicate if you are required to fulfill a US military active duty commitment or in deferment. If yes, enter additional details.

Felony or Indictable Offense and Misdemeanors

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).

Health Care 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.

Identifiers

Enter your medical IDs, if applicable.

 

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