Graduate PA Virtual Interview

Have you ever been disciplined by any college, university, or professional school for unacceptable academic performance (academic probation, suspension, dismissal, etc.) or conduct violations?

Yes

No

Please use this space to provide a brief explanation or additional information on this matter to our committee.

Answers to the following questions will not impact your ability to interview for our program. However, certain responses may be reviewed to determine your eligibility to seek future licensure/employment in this field.

Have you ever plead guilty to or no contest to a misdemeanor criminal offense, or been found guilty by a court of such a criminal offense?

Yes

No

Please use this space to provide a brief explanation or additional information on this matter to our committee.

Have you ever plead guilty or no contest to a felony criminal offense, or been found guilty by a court of such a criminal offense?

Yes

No

Please use this space to provide a brief explanation or additional information on this matter to our committee.

Criminal Background Check Acknowledgement: By selecting this box I understand that if I am admitted to this program after I interview, and choose to enroll, I will be required to take part in a formal background check. I understand that certain conduct may prevent me from participating in required clinical experiences and future licensure/employment in this field. In addition, specific conduct may prevent me from obtaining campus housing. Results provided through the background check process may be used by Le Moyne College in determining my eligibility to participate in this program and/or my future ability to secure licensure in this profession.

I understand that representatives in the Office of Graduate Admission are available to assist with questions pertaining to criminal background and I can contact their office at GradAdmission@lemoyne.edu at any point in the admission process without impacting my potential admission decision.

Acknowledgement