PA Application Checklist Bachelor s degree (from a U.S. regionally accredited institution)

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1 PA Application Checklist Bachelor s degree (from a U.S. regionally accredited institution) Cumulative GPA of 3.0 or higher Official transcripts from all schools attended Pre- requisites course work (from U.S. regionally accredited institution) Human Anatomy and Physiology with lab two semesters or three quarters General Biology with lab one semester or two quarters Additional Biology with lab one semester or two quarters Microbiology with lab one semester or two quarters General Chemistry with lab one semester or two quarters Additional Chemistry with lab one semester or two quarters Organic Chemistry with lab one semester or two quarters Statistics (business statistics not accepted) one course Psychology one course Medical Terminology (may be waived in certain circumstances) one course Minimum of 2.7 [equal to a B- ] in each course required With the exception of Psychology and Medical Terminology, survey courses do not meet the prerequisite requirements (usually a 100 or 101 class) Military applicants may have met prerequisite course requirements in their training. For example, USAF Pararescueman training includes 12 SH of Emergency Medicine, 4 SH of Anatomy and Physiology, and 3 SH of Psychology. The decision to accept or decline military training, as meeting a prerequisite, is at the discretion of the PAS program director. Since no letter grade is provided in these courses, they will be accepted when successful completion can be proven (DD214 verification). Prerequisites met via Advanced Placement credit (college equivalent courses taken in high school), where no letter grade is provided, will be accepted based on pass/fail criteria. Transcripts must show a pass grade was met. Health Care Experience Patient care experience form reflecting the number of claimed hands on clinical experience Documentation of Physician Assistant shadowing hours (date, time, type of provider, type of practice) Additional Requirements GRE (all results are accepted) Three letters of recommendation (one must be from a physician assistant) Documentation supporting all volunteerism to include dates (mission, community volunteerism, etc.) TOEFL for all students where English is not their primary language Internet- based TOEFL: Score of 100 with a minimum score of 20 on each section. A total score of 600 on the paper TOEFL, with a score of 55 on the Listening Comprehension. A total score of 250 on the computer- based TOEFL. A level 112 from the ELS Language Centers or other recognized evidence may be considered satisfactory, pending the Admissions Committee approval.

2 Reference Form Reference Name (Print): Relationship to Applicant: Reference Name (Signature): 1. Ethics: Applicant displays strong ethical and moral judgment 2. Professionalism: Applicant is self- aware and can rise above personal opinions 3. Interpersonal Relationships: Applicant has cultural sensitivity and has shown empathy when appropriate 4. Ability to Manage: Applicant is able to multi- task 5. Communication Skills: Applicant has good verbal, non- verbal, and written skills 6. Collaborative Skills: Applicant works well with others 7. Ability to Perform: Applicant is able to function well when under stress

3 Reference Form Reference Name (Print): Relationship to Applicant: Reference Name (Signature): Comments (please limit comments to one paragraph): Please mail this form directly to Gardner-Webb University Physician Assistant Studies Program: Physician Assistant Studies Graduate Admissions Gardner-Webb University PO Box 7308 Boiling Springs, NC If you have questions, please call or toll free I waive do not waive rights to see the information supplied by this reference Physician Assistant Applicant (Signature) Date

4 Physician Assistant Direct Health Care Experience Verification Form The program places importance on health care familiarity and evaluates the quality and quantity of an applicant s experience with direct patient health care. Shadowing experience, although highly valued, does not count toward the total number of hours. Health care experience will be evaluated on the type of experience and the number of hours performed. Examples include (but aren t limited to) the following. Volunteering at marathons, blood donor clinics, fundraising for medical causes, after- school programs, coaching, church reader, meals- on- wheels, research technician, lab- based researcher, unit secretary, ward clerk, peer educator, reader or other non- medical work in waiting room or other medical setting, medical lab technician, medical technologist, athletic trainer, audiologist, exercise physiologist, radiology technician, phlebotomist, optometry technician, registered dietician, patient care assistant, PT assistant, medical scribe, medical assistant, PT, RT, OT, MSW, EMT, LPN, chiropractor, RN, CNA, nurse s aide, medic or corpsman, paramedic, OD, and foreign medical graduate. Note: When volunteering, it is important that you are able to observe or participate in direct patient care. A letter on official office stationary from each employer or volunteer office must be submitted with this form. This letter should outline the dates of occurrence, total hours worked and the type of duties performed. Direct Patient Care Experience Institution: Location: Phone Number: Dates of Experience: Total Number of Hours: Signature of Applicant Date

5 Physician Assistant Shadowing Form Physician Assistant s Name (Print): Physician Assistant s Signature: The Gardner- Webb University Physician Assistant Studies Program values previous exposure to the PA profession. If you have supported this process and allowed this applicant to shadow you during performance of your Physician Assistant duties, please provide answers to the following. Date/s: Type of Practice: Describe Experience (please be specific): Please mail this form to Gardner- Webb University s Physician Assistant Studies Program: Graduate Admissions Gardner- Webb University PO Box 7308 Boiling Springs, NC If you have questions, please call or toll free

6 Volunteerism Form Supervisor s Name (Print): Relationship to Applicant: Gardner- Webb University s Physician Assistant Studies Program values an applicant s service history. If you have supervised this applicant in a service arena (mission trips to underserved sites in the US and abroad, big brother, big sister, Special Olympics, church events, etc.) please provide answers to the following. Date/s: Location of Event: Type of volunteer work (please be specific): Please mail this form directly to Gardner- Webb University Physician Assistant Studies Program: Graduate Admissions Gardner- Webb University PO Box 7308 Boiling Springs, NC If you have questions, please call or toll free