Application for HPC Interview

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Application for HPC Interview - Spring 2021

PLEASE NOTE: Information the applicant does NOT wish to disclose to health professional schools should NOT be included on this form. Applicants are welcome to discuss issues they are unsure about disclosing with the HPC Chair (Kevin Crisp).

Email *

Applicant Name *

First, Middle, Last

Graduation Year *

State Residency *

Cumulative GPA *

Preferred Email *

Preferred Phone Number *

Can you receive text messages at this number? *

Yes

Today's Date *

YYYY

Please enter your name below, which indicates that you HAVE SUBMITTED AN ELECTRONIC COPY OF THE FERPA AGREEMENT THROUGH SIS. If you are an alum, you must submit via: http://wp.stolaf.edu/pre-health/reference-request/ *

*Your submission of the electronic FERPA form (through SIS) for the Health Professions Committee (HPC) and faculty evaluators, is your way of requesting and authorizing the HPC and your Faculty Evaluators to prepare a committee Letter of Evaluation and Faculty Evaluation Forms for submission to professional schools to which you will apply. It also indicates that you understand that the HPC has access to your transcript, your test scores, and reports on disciplinary action from the Associate Dean of Students. Finally, your submission of the FERPA form waives your right of access to the Health Professions Committee Letter, the Faculty Evaluation Forms, and all contents of your HPC dossier.

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