MASTER OF SCIENCE IN PHYSICIAN ASSISTANT PROGRAM SUPPLEMENTAL APPLICATION
FOR JANUARY 2013 START DATE
DEADLINE FOR APPLICATION: NOVEMBER 1, 2012
Primary language spoken at home (required):
1. Explain specifically why you want to attend Keiser University's Physician Assistant Program. (Essay):
2. Explain any gaps of greater than one year in your resume:
3. Have you ever been enrolled in another PA program? if so, which program? When?
4. Please explain any withdrawals, failures, or leaves of absence on your transcripts:
By typing your name you have created an electronic signature as legally binding as your handwritten signature.