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Physician Assistant Fast Track Application Registration

The Physician Assistant Fast Track Application is only available to students who are currently enrolled full time at the University of Charleston.

PA Program Registration Information

Welcome to the Physician Assistant Fast Track Application Registration!

Please create your account login information and begin answering the application questions.

If you have already registered, click here to login.

Once you submit this form, you will receive an email asking you to confirm your registration.  You MUST confirm your registration, otherwise; you will not gain access to finish and submit your application.

The login information you create is case sensitive.

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Create your Login Information

Note:  This serves as your username.


At least 8 characters long.
Contain 4 unique characters.
Contain 2 digits or symbols

Re-enter password:
Name Information
First Name:  *
Middle Name:
Last Name:  *
Suffix (Jr., II etc...):
Maiden Name:
Background Information
Date of Birth:    Click Here to Pick up the date *
Gender (M)ale - (F)emale: F  *
Which of the following best describe your race? (you may mark more than one)
 American Indian or Alaska Native
 Black or African-American
 Native Hawaiian or Other Pacific Islander
Is English your primary language? No Yes  *
What is the type of geographic area where you were raised?  *
Phone & Current Address Information
Day Time Phone:  *
Address:  *
City:  *
State/Province:  *
Postal Code:  *
Country:  *
Permanent Address Information
Address:  *
City:  *
State/Province:  *
Postal Code:  *
Country:  *
PA Program Registration Information
How did you learn about the PA Program at UC?
(you may mark more than one)
 From a Friend
 Direct Mail
 Program Website
 School Counselor
 Physician Assistant Education Association
If you selected OTHER, please tell us how you learned about the PA Program:
PA Admission Pathway  *
Matriculating Year Spring of  *
Important Information for PA Program Applicants

In an effort to help those interested make a fully informed decision about applying to and matriculating into the University of Charleston Physician Assistant Program (UCPAP), here is a list of our program policies.

By checking this box, I hereby acknowledge that the information indicated in the above list has been made available to me.
Initials:  *
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For questions about the application and/or application process, please contact Pam Carden, Admissions Coordinator at 304-357-4968 or

Have a technical question or need technical help? Please contact the Web Administrator at 304-357-4842 or
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