This form will be used to determine the PA status of any visitors to this site. No information will be made public unless you give me the OK!!

The personal info (age, where from, etc) will be used to gather statistical info on the average PA applicant, etc.

What's your first name or nickname?

How old are you?        Where are you from? College or State

What is your current status?
Choose one... Currently in a PA program I'm a PA Starting a PA program soon Trying to get into a PA program I work for a PA program Other     If OTHER, please specify:

Please elaborate on your above choice:

Can I add your information to the Graffiti wall?
Sure, go for it!
No way, are you crazy!

Any Comments/Suggestions you'd like to add for other readers?
Are there other points you'd like to see added to this page?