To be completed by applicant:

By signing below I understand that all degree requirements must be complete prior to beginning the program. If I am

unable to complete requirements by the deadline it is my responsibility to inform the program immediately which could



Applicant Signature: _____________________________________________________________________________

Date: _____________________________________ Application Year ________________________________

This form must be uploaded to OTCAS and submitted by the

application deadline.

To be completed by academic advisor, program chair, or equivalent.

Based upon courses previously completed and successful completion of a projected plan of study, the following applicant is

expected to meet the requirements for a baccalaureate degree prior to the August start date.

Applicant Name: ______________________________________________________________________________________

College or University granting degree: _________________________________________________________________

Degree: _________________________________ Major: _____________________________________________________

Degree requirements to be completed Month: ________________ Day: _____________ Year: ______________

IU South Bend Vera Z. Dwyer College of Health Sciences