School of Occupational Therapy Supplementary Application Fee Payment Form Thank you for applying to the School of Occupational Therapy at University of Puget Sound. An application fee in the amount of $50 is required. At this time we accept payment by paper check only, payable to University of Puget Sound. In the subject line of the check, please reference the applicant’s full name, OTCAS ID number, and the OT program (for example: “Robin Smith, 20112112939, OT”). A paper copy of this completed form is required with your check, postmarked by December 1. Please send this form together with your check by postal mail to: University of Puget Sound Office of Admission 1500 N Warner CMB 1062 Tacoma, WA 98416 Applicant Information Please complete the information below in full. You may type your information into the form fields before printing this page. OTCAS ID / / Date of birth (MM/DD/YYYY) Last name First name Middle initial Email address (same applicant address used with OTCAS) rev. 9/14 KH