Matriculation

Enrollment Services

200 University Parkway, IHL 101
Yakima WA 98901
Phone: 509.249.7888
Fax: 509.249.7907
Welcome to PNWU! This form gathers information from you to assist us in preparing for your arrival. Please review the form before beginning. All required fields have a red * and are necessary in order to submit. There is not an option to save before submitting.
Doctor of Physical Therapy Student Matriculation Information
Full name (can be your preferred name if different than your legal name)*

First NameMiddle NameLast NameSuffix
PNWU ID Number (no dashes)*
Nick name
Full name phonetic pronunciation*
DPT Program Polo Shirt

You will be provided a DPT program polo shirt for clinical site experiences. Please use the charts below to select your size.

Polo Shirt Sizing Charts (right click to open links in a new tab)

Womens	XS	S	M	L	XL	2XL	3XL	4XL
Chest	18	19	20	21 1/2	23	24 1/2	26 1/2	28 1/2
Sleeve	14	14 1/2	15	15 3/4	16 1/2	17 1/4	18 1/4	19 1/4
Body at back	26	26 1/2	27	28	29	30	30 1/2	31

Mens	XS	S	M	L	XL	2XL	3XL	4XL
Chest	18	19 1/2	21	23	25	27	29	31
Sleeve	17 1/8	18	18 7/8	20	21 1/8	22	22 7/8	23 3/4
Body at back	27 1/2	28 1/2	29 1/2	30 1/2	31 1/2	32 1/2	33	33 1/2

Women's polo description Men's polo description

Polo Shirt Type*

WomenMen
Polo Shirt Size*

XSSMLXL2XL3XL4XL
Anatomy Scrub Set

You will be provided a single pair of scrubs for anatomy lab. These scrubs tend to run a little big as they are unisex scrubs. Please use the chart below to determine the sizing.
Unisex V-Neck Tunic Size*

XXSXSSMLXL2XL3XL4XL5XL
Unisex Drawstring Cargo Pant Size*

XXSXSSMLXL2XL3XL4XL5XL
Unisex Drawstring Cargo Pant Length*

RegularPetite/ShortTallUltra Tall
A magnetic nametag will be provided for clinical experiences, please provide the name you would prefer on the nametag?*
Name preferred on magnetic nametag for clinical experiences.
I have a pacemaker.*

YesNo
Dietary Needs?

Dairy freeGluten freeNut freeVeganVegetarianOther
Do you need any accommodations for Orientation?

NoYes
Upload a picture of your driver's license or other government ID*

Browse Files
Use a .jpg, .jpeg, .tif, .gif, or .png file type. Cancelof
Text/SMS Number*
Used in case of emergency on campus.
Email Address*
Place you consider your home town and state*
Marital Status
Name of spouse, partner, or significant other

First NameMiddle NameLast NameSuffix
Relationship
Do you have children?

YesNo
Number of children
Getting To Know You

The PNWU community would like to get to know you before you arrive. Please provide your career or educational highlights, any interests or hobbies, or other details you would like to share. This information will be available to faculty, staff, and your PNWU colleagues.
Personal Bio

0/100
White Coat

PNWU will have white coats for the white coat ceremony. Please use the charts below to indicate your size.
White Coat Type*

WomenMen
White Coat Size*

XXSXSSMLXL2X3X4X5X
You are required to have a laptop as a PNWU student. Do you anticipate having a Mac or PC?

MacPC
Students will have assigned lockers. Please indicate if you have a locker location preference (assignment will be based on availability, preference is not guaranteed).

TopMiddleBottomNo preferenceI do not want a locker
PNWU Emergency Alert

This is an emergency notification system that allows the University to quickly disseminate an urgent message through multiple communication channels including:

-Voice messages to cell, home and office phones

-Text messages to cell phones

-Email messages

All enrolled students, faculty and staff will be automatically entered into the PNWU Emergency Alert System. If you wish to opt‐out of the text messaging feature, please check the button below.
PNWU Emergency Alert Text Messaging Feature*

Opt-inOpt-out
Disclaimer
I understand that I have chosen to opt‐out of the PNWU Emergency Alert text messaging feature that is used to disseminate an urgent message when an emergency occurs at the University. Furthermore, I understand by opting out of PNWU Emergency Alert text messaging, an emergency notification will still be sent to my PNWU provided email address and voicemail messages will be sent to the PNWU provided office number (Faculty and Staff only).

Should I choose at a later date to receive PNWU Emergency Alert text messages , I understand that I may update my preferences by using the PNWU Emergency Alert - Contact Information Update form.
In the event of an emergency involving a Pacific Northwest University (PNWU) student, PNWU may contact the person the student has designated as his/her Emergency Contact. If the student is considered by a representative of PNWU in their judgment to be in a physical or mental crisis, the representative may contact the student’s designated Emergency Contact. By providing the name and phone number of an Emergency Contact in the Self-Service system, the student is granting PNWU the authority to notify the Emergency Contact of the student’s condition.
Emergency Contact #1

First NameLast Name
Relationship with #1
Phone Number of #1

Area CodePhone Number
Emergency Contact #2

First NameLast Name
Relationship with #2
Phone Number of #2

Area CodePhone Number
Public Announcement

PNWU would like to announce the news that you are beginning physical therapy school to a newspaper of your choice. Please be aware that the information is published based on the discretion of each publication but we will do our best to share your news.
Newspaper Name
Newspaper City & State
Newspaper press release email address
Newspaper press release phone number

Area CodePhone Number
Should be Empty:

Doctor of Physical Therapy Student Matriculation Information