Radiation Therapy Program Application

Personal Information



Academic References

Please list persons not related to you-- for example, professors, program directors or instructors. *At least two references should come from instructors.

Reference #1

Reference #2

Reference #3

Current/Formal Employment

Personal Information

By checking the box above, I understand that any false statements made as part of this application, will be considered as sufficient cause for application disqualification. I also grant permission to the authorities of this school to investigate any references, and I release the school from any and all liability resulting from such investigation. I consent to any and all medical examinations required by the school to be considered for program admission. Upon completion of the program, I authorize the release of any academic performance information as a student in the program to potential employers. Admission to the University of St. Francis School of Radiation Therapy is granted without regard to race, color, religion, gender, age, disability or national origin.