Matriculation

Enrollment Services

111 University Parkway, Suite 202

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.

Full name (can be your preferred name if different than your legal name) *

First Name Middle Name Last Name Suffix

Nick name

Full name phonetic pronunciation *

Upload a picture of your driver's license *

Browse Files

Use a .jpg, .jpeg, .tif, .gif, or .png file type.

PNWU ID Number (no dashes) *

Text/SMS Number *

Used in case of emergency on campus.

Email Address *

Place you consider your home town and state *

Dietary Needs?

gluten free, vegan, vegetarian, etc.

We want your transition to the Yakima Valley to be as smooth as possible. In order to better serve you, we are interested in finding out about any person(s) that will be moving with you.

Name of spouse, partner, or significant other

First Name Middle Name Last Name Suffix

Relationship

Will you have children moving with you?

Yes No

Number of children moving with you

Anatomy Scrub Set

You will be provided a single pair of scrubs for anatomy lab. Please use the chart below and select your size.

Scrub Size

XS S M L XL 2X 3X 4X 5X

Scrub Length

Regular Short Tall

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

Mac PC

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

Top Middle Bottom No preference I do not want a locker

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

0/75

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-in Opt-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 his/her 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, the student is granting PNWU the authority to notify the Emergency Contact of the student’s condition.

Emergency Contact #1 *

First Name Last Name

Relationship with #1 *

Phone Number of #1 *

Area Code Phone Number

Emergency Contact #2

First Name Last Name

Relationship with #2

Phone Number of #2

Area Code Phone Number

Public Announcement

PNWU would like to announce the news that you are beginning medical school and participation in White Coat Ceremony 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 Code Phone Number

Matriculation Information