I certify that all of the application's information is my own work, factually true, and honestly presented. My electronic submission of my full name below is equivalent to my signature and is a certification of the accuracy and completeness of the information I have provided. Further, I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false.
I also understand that as a student, it is my responsibility to understand the licensure requirements of the state or country where I seek to be licensed and that it is not the responsibility of the University of Health Sciences Antigua if those state or country regulations change during my medical education.
I hereby grant permission to the University of Health Sciences Antigua to reproduce any portion of photo images or video that have been taken on-campus, at clinical clerkships, or at any university-sponsored event to be used for the purpose of promotional publications, which can include but is not limited to, books, cards, calendars, invitations, and websites without any more compensation or recognition given to me. Furthermore, I grant creative permission to alter the photograph(s). I do not grant permission to resale or use the photographs in a manner that would exploit or cause malicious representation toward me or my company and associates.
Please accept the terms & conditions to submit this form.