UWL OT Application PMA - 05/15 DEADLINE DATE: MONDAY, JAN. 4 MASTER OF SCIENCE IN OCCUPATIONAL THERAPY PROGRAM APPLICATION

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1 PMA - 05/15 DEADLINE DATE: MONDAY, JAN. 4 MASTER OF SCIENCE IN OCCUPATIONAL THERAPY PROGRAM APPLICATION Applicant Name: UW-L ID: Address: PRE-REQUISITE COURSE WORK COMPLETED Required Courses Abbreviated Course Title and Department Year / Semester Taken Grade Credit Hours Indicate UWL or Other Institution Human Anatomy / A&P I Human Physiology / A&P II Physics Life-Span Development / Developmental Psychology Statistics / Research Principles Sociology / Anthropology Abnormal Psychology For Fall 2015 courses please list CE in the Grade Received column. For UW-L students Fall 2015 grades will be accessed via WINGS over winter break and included in prereq grade calculations and evaluations. Non UW-L students are encouraged to submit an updated official transcript that includes Fall 2015 grades. For Spring 2016 courses please list PE in the Grade Received column. Are you enrolled in the UW-La Crosse Dual Degree Program: YES or NO Students must complete a one credit Medical Terminology course during their first semester in the program. Those who have already completed an equivalent course are exempt from taking this required course. Have you completed a Med Term course? YES Enrolled NO When? Course #? 1

2 Applicant Name Personal Narrative/Autobiography Please respond to the following questions by typing your responses in the space provided. Please limit your responses to the space provided. Responses exceeding the two pages provided will not be considered. At the end of your last narrative you must include the following statement: I am the sole author of these essays. 1. Discuss how occupational therapy is a good fit for you. 2. Discuss how your life experiences have helped you develop team skills, work ethic, and a commitment to working with people. 3. Discuss your experiences working with patient populations (i.e. work experiences, job shadowing, volunteering, and/or class experiences). What did you gain from these experiences? 2

3 Applicant Name: 3

4 Applicant Name: Instructions: 1. Submit a UW-La Crosse Graduate School application via the UW System. This can be completed online at the following address: A non-refundable application fee of $56 is required. 2. Submit official transcripts for all college and university coursework attempted by the Monday, January 4 deadline to: UW-La Crosse Graduate Admissions Office Cleary Center La Crosse, WI Note: UW-L students and alumni do not need to forward UW-L transcripts. 3. Submit UW-L Master of Occupational Therapy application materials (i.e., resumé, etc.) by the Monday, January 4 deadline, including the non-refundable $50 OT program application fee payable to University of Wisconsin-La Crosse to: UW-L OT Program 4033 HSC La Crosse, WI NOTE: Failure to submit all of your application materials by Monday, January 4 will result in your application not being reviewed. I attest that the information furnished in this application is accurate. Signature of Applicant Date NOTE: Your completed application, including all supporting materials, must be submitted no later than Monday, January 4 for consideration for admission to the program for the following June. Failure to have all materials submitted by the deadline will cause your application to not be reviewed. 4

5 OT Application Checklist Required Electronic Materials for Graduate School: - Graduate School application submitted electronically at - $56 Graduate School application payment submitted electronically Required Materials to Mail to Graduate School: - Official transcripts from all colleges/universities attended o UW-L Students: UW-L will include your transcript with your application Direct transcripts to: UW-L Graduate Admissions Office Cleary Center La Crosse WI Required Materials for OT Program Included in Mailing: - OT Program application - $50 OT application payment - Professional Resumé Direct OT Program mailing to: UW-L OT Program 4033 HSC La Crosse WI Completion of Personal Potential Index (PPI) via ETS