DPT Seat Deposit 2022

Doctor of Physical Therapy Offer of Admission to Class of 2022
Please check one of the following boxes to indicate your decision to either accept or decline the South College School of Physical Therapy Offer of Admission into the Doctor of Physical Therapy (DPT) Class of 2022. Receipt of the non-refundable deposit is required to definitively secure your seat in the DPT Class of 2022.

By accepting the offer of admission, I understand and agree that if I do not complete all admission requirements 2 weeks prior to the start of the program, this offer of admission may be withdrawn. I have read, understand, and agree to the South College School of Physical Therapy DPT Admission Requirements.

I am submitting electronic payment for one thousand five hundred dollars ($1,500.00) to South College. This deposit is to hold a place for me in the DPT Class of 2022 and will be applied directly to my tuition and fees when I matriculate into the program. I understand that this deposit is non-refundable. Accordingly, I understand and agree that this deposit will be forfeited if I (1) fail to register, (2) later withdraw my acceptance of the offer of admission, (3) fail to provide a clean background check prior to matriculation, or (4) fail to complete all admission requirements 2 weeks prior to the start of the program.

Last Name (required):*
First Name (required):*
Middle Name:
Maiden Name:
Date of Birth:*
Social Security Number:*
Please list the telephone number at which you can be reached between 8:00am and 5:00pm EST (required):*
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Home Telephone:
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Cell Telephone:
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Email (required):*
Address (required):*
*By entering your full name, the last four digits of your social security number, and submitting the document, you electronically agree and confirm your understanding of the items, as outlined, in the above document as well as authorize the payment of the admission fee to South College.
*As acceptance of this registration, please type your full name below.
Applicant Signature:*
*Please enter the last four digits of your social security number.
Last Four of Social:*
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