grand valley state university · web viewhuman anatomy human physiology microbiology prerequisite...
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CAMPUS: (CHECK ONLY ONE) ☐ Grand Rapids ☐ Traverse City
Requests must be submitted with supporting documentation. Include copies of unofficial transcript from ALL schools attended.
√ Type of Request Supporting Documentation5-Year Course Requirement Waiver… check all that apply
▪ Brief, detailed statement indicating when and where you took the class along with what you have been doing to keep your knowledge base of the course material up-to-date.
▪ Resume (if applicable)▪ Actual documentation of course (i.e. unofficial
transcript(s))
☐ Biochemistry ☐ Human Anatomy
☐ Human Physiology ☐ Microbiology
Prerequisite Substitution… check all that apply ▪ Provide course description and syllabus▪ Brief, detailed statement indicating when and
where you took the class along with reasoning for request.
▪ Actual documentation of course completion (i.e. unofficial transcript(s))
☐ General Biology☐ General Chemistry ☐ Genetics ☐ Organic Chemistry ☐ Biochemistry☐ Human Anatomy
☐ Human Physiology ☐ Statistics☐ Psychology☐ Microbiology ☐ Physics
Course Completion ExtensionThe following courses MUST be completed at time of application:
▪ Brief, detailed statement indicating the reason or circumstance for the request
▪ Supporting documentation (Requires letter from academic advisor or registrar confirming reason that course has not been completed)▪ Copy of unofficial transcript(s)
☐ Organic Chemistry ☐ Biochemistry ☐ Human Anatomy
☐ Human Physiology☐ Microbiology
Other Request (write in type of request below)
▪ Brief, detailed statement indicating the reason for the request
▪ Supporting documentation
GVSU PAS Admissions Committee Official RecommendationThe decision made by this committee is final.
Date/Initial Status RemarksApproved
Conditionally Approved
Denied
Grand Valley State UniversityPhysician Assistant Studies (PAS)
Admissions Academic Request FormName: ________________________________ Date: _______________________
GVSU G# (if applicable): ________________________________
Email: _______________________________ Phone: _______________________
2019 Fall ApplicationAcademic Request Deadline
July 15, 2019
For consideration for fall 2019 application cycle, which ends September 1, 2019, this completed form, and necessary supporting documentation, must be received by GVSU PAS Admissions Committee at
[email protected] on or before July 15, 2019. Please allow 4-6 weeks for processing.