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Supplemental Application
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INTERNATIONAL EDUCATION

CARROLL UNIVERSITY
PHYSICIAN ASSISTANT SUPPLEMENTAL APPLICATION
14-15 Application Cycle
Requirements and Deadlines

APPLICATION CHECKLIST

All of the following application materials must be received by the Carroll University Graduate Admission office by October 1, 2014.

  • Verified Central Application Service for Physician Assistants (CASPA) application (www.caspaonline.org).
  • Carroll University Supplemental Application:
    • Autobiographical Information
    • Essay
    • Safety and Technical Standards
    • Application fee of $25.00. The application fee is required by all candidates. You will be prompted to provide electronic payment after submitting. A payment verification email will follow.
  • Three (3) letters of reference (submitted via CASPA), preferably from:
    • a A college instructor
    • b Supervisor from a work or volunteer clinical experience
    • c Approved health care professional such as PA, NP, MD or DO.
  • Official GRE scores submitted directly to CASPA using Carroll University program code. 0409.

Special Note: As an applicant, you are responsible for the quality and content of your materials. Failure to submit a completed application through CASPA (www.caspaonline.org) AND a completed supplemental application with the required $25.00 application fee will prohibit the processing of your application.

Carroll University does not discriminate in any manner contrary to law or justice on the basis of race. Color, gender, age, sexual orientation, religion, disability, veterans' status or national origin in its educational programs or activities, including employment and admissions.

Carroll University admits students based on academic qualifications. Data collected from optional questions is used for research and provision of special services.

If you have any questions regarding the submission of the supplemental application, please call (262) 524-7361 or email painfo@carrollu.edu..

Supplemental Application
A. Autobiographical Information  
*Last name:
*First name:
Middle name:
Please indicate if any of your records are under a different name(s):
*Current Mailing Address:
*City:
*State:
*ZIP:
Current address is effective until: Date:
*Phone number:
*Email address:
*CASPA ID
*Gender:
Citizenship (Check one):



If other, please explain:

B. ESSAY: We are committed to building a superb educational community with students of diverse talents, experiences, opinions and backgrounds. Please provide examples of how your past experiences in and out of the classroom have prepared you to support the mission of the Carroll University PA Program and the PA profession.
* Please type or paste your response in 250 words or less in the space provided.

C. Technical Standards for Admission to and Progression in the Physician Assistant Studies Program

The Physician Assistant Studies Program requires that a student possess the ability to meet the requirements of the program. Though the program might modify certain course requirements to provide persons who are handicapped with an opportunity to achieve results equal to those of a person who is not handicapped, there are no substitutes for the following essential skills. The applicant must initially meet these requirements to gain admission to the program, and must also continue to meet the University’s published technical standards throughout participation in the program.  Technical standards may be revised from time to time to meet accreditation or program needs.

  1. Physical requirements: The applicant/student must be willing and capable of performing the customary techniques for physical assessment, such as visual observation, auscultation, percussion and palpation. The applicant must be able to perform physician assistant procedures such as suturing, splinting, venous and arterial puncture and cannulation, bladder catheterization, nasogastric tube placement, emergency procedures such as cardiopulmonary resuscitation, suctioning of airway, endotracheal intubation, operation of cardioverter/defibrillator, and application of routine first aid procedures.
  2. Communication: The applicant/student must be able to elicit information, describe changes in health, mood and activity, and perceive nonverbal communication. The applicant/student must be able to communicate effectively and sensitively with patients and all members of the health care team.
  3. Intellectual ability: The applicant/student must be competent in problem solving skills, including measurement, calculation, reasoning and analysis.
  4. Behavioral and social attributes: The applicant/student must be able to tolerate physically taxing workloads, function effectively under stress, adapt to changing environments, display flexibility, learn to function in the face of uncertainties inherent in the evaluation and treatment of patients, and must possess integrity, compassion, effective interpersonal skills and be motivated for a career in health care. The student/applicant must be able to work with patients who have serious illnesses, infectious or terminal diseases and severe emotional disorders.

The Physician Assistant Studies Program requires that the applicant/student undergo a physical examination. An applicant/student who is handicapped shall not, on the basis of his or her handicap (except those which would preclude the essential skills outlined above), be excluded from participation in, denied the benefits of, nor be subjected to discrimination in the physician assistant program.

I have read and understand these technical standards. I am able to meet these minimum standards, with or without reasonable accommodation, for successful completion of degree requirements.   

*Date
:

I certify that the information given on this application is complete and correct to the best of my knowledge without omission or misrepresentation of facts. I have not attended institutions other than those listed in my CASPA application.  If any changes occur in the information furnished on this or the CASPA application that I am required to report these changes to the MSPAS program. I understand that I am responsible for arranging for the forwarding of official transcripts from all schools I have attended and that such transcripts become the property of Carroll University and will not be returned. I understand that if I am admitted, all of my prerequisites must be satisfactorily completed by the end of Spring semester, 2015 before I can begin classes in Summer, 2015. I understand that any falsification on my records may be cause for the university to void my admission or registration or to take other appropriate action. I understand that some degrees, majors and/or courses may require me to submit to criminal background investigation and/or drug testing. I further understand that the results of those checks and/or test may affect my eligibility to continue in that degree, major and/or course.

*Date:

 
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