University of Health Sciences Antigua

Personal Information

First Name^*

Last Name^*

Additional Names

Social Security Number

U.S. citizens and permanent residents

Date of Birth^*

Country of Birth^*

Country of Citizenship^*

Gender^*

Email^*

Primary Telephone^*

Passport photo

Upload a passport sized photograph of yourself.

How did you hear about UHSA?^*

Mailing Address

Address^*

Address 2

City^*

State/Province^*

ZIP/Postal Code

Country^*

Emergency Contact

Emergency Contact Name^*

Emergency Contact Telephone^*

Relationship^*

Program Information

Application Type^*

Students seeking readmission should not complete this application. Please complete the appropriate application.

Program of Interest^*

Anticipated Start Date^*

Medical school entry dates occur in January, May, and September.
Nursing school entry date only occur in September.

Academic Information

High School Name^*

High School Entry Date^*

High School Graduation Date^*

High School Diploma

For Premedical Sciences and Nursing students, a copy of your official high school diploma can be uploaded while we wait for your official copy. Please note an official copy is required for admission.

University Name

University Entry Date

University Graduation Date

Unofficial University Transcripts

A copy of your unofficial university transcripts can be uploaded while we wait for your official copy. Please note an official copy is required for admission.

University/Medical School Name

University/Medical School Entry Date

Unofficial University/Medical School Transcripts

A copy of your unofficial university and medical school transcripts can be uploaded while we wait for your official copy. Please note an official copy is required for admission.

Supporting Information

Personal Statement (400 Word Minimum)^*

Your personal statement is your opportunity to describe who you are and why you are uniquely qualified for a career in the health professions beyond class performance and standardized test results. Advocate for yourself.

TOEFL Exam Score

Pleases upload a copy of your TOEFL Exam Score if available.

MCAT documents (if any)

Pleases upload a copy of your MCAT Exam Score if available.

If you have previously applied, please the enter the date of your most recent application

Have any of your immediate family members ever attended our institution?^*

If Yes, please provide their names

Have you ever been dismissed/expelled and/or required to withdraw from medical school for any reason?^*

Please explain (if yes)

Academic Honors (Please List)

Extracurricular activities (in-school)

Have you ever been convicted of a criminal offense (felony or misdemeanor)?^*

Please explain (if yes)

References

Full Name (Reference one)

Email (Reference one)

Telephone (Reference one)

Reference Type (Reference one)

Full Name (Reference two)

Email (Reference two)

Telephone (Reference two)

Reference Type (Reference two)

Fees

Mandatory Fees
	Application	75.00
	Total	75.00

Apply to UHSA

Personal Information

Mailing Address

Emergency Contact

Program Information

Academic Information

Supporting Information

References

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Apply to UHSA

Personal Information

Mailing Address

Emergency Contact

Program Information

Academic Information

Supporting Information

References

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