School of
Physical Therapy
Supplementary Application Fee Payment Form
Thank you for applying to the School of Physical 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, PTCAS ID number, and the PT
program (for example: “Robin Smith, 20112112939, PT”). A paper copy of this completed form is required
with your check, postmarked by November 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
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Please complete the information below in full.
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You may type your information into the form fields before printing this page.
PTCAS ID
/
/
Date of birth (MM/DD/YYYY)
Last name
First name
Middle initial
Email address (same applicant address used with PTCAS)
rev. 9/14 KH