Philadelphia College of Osteopathic Medicine - Synapsis Yearbook (Philadelphia, PA)

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This application must be filed before January 1st of the calendar year of desired matriculation Philadelphia College of Osteopathic Medicine 4150 City Avenue, Phladelphia, Pennsylvania 19131 APPLICATION FOR ADMISSION To be considered by the Faculty Committee on Admissions this application must be completed in its entirety. For Class entering 19742 Unless otherwise indicated herein. please type or print. If admitted at a modem. you will be required to submit two (2) walkt•sized (2W z 3 ' ) prints of a full-fared photograph which has ban especially photo. graphed in a studio. Male sttn dents arc to wear a coat and tie for the photo. Women au• dents are to wear business or strew site for the photo. of this Application Z 14 PERSONAL INFORMATION Name in full •Inet TIATIC DOLT .1•11C ‘AIEC Home Address -ILI Sot E444e4 .- AMO CCCCC T CITY COVAITT Mailing Address S Date of Birth 14 U. S. Citizenship: Yes (A No ( ) Home Phone Number of Other Single ( ) Married (); Divorced ( ) Children (44 dependents Social S«urity Y Give the name and relationship ofall relatives in the Osteopathic Profession: PARk.C.3.1 4S WCLBY .O. ; se); rthnis ifringe ,D. oi; ToSt D. o. Have you previously applied for admission to this college? No Yes ( ). Applied for class to start September HEALTH HISTORY Give a brief statement as to any physical and psychiatric, minor and major illnesses: surgery; physical impairment: Ate AS yet S Wear glasses: No ( ) Yes (X? Height 0 g Weight ep. . .

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be unpleasant to those that deserve it. Shadwell

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Philadelphia College of Osteopathic • lane SPRUCE STREET AT 48TH PHILADELPHIA. PA. 19139 (210748-1000 April 1, 1970 Mr. H. Madden Walcheck 123 S. Dengrove Avenue LaPorte, Pennsylvania 18626 Dear H. : I am pleased to inform you that your application for admission into the First Year Class in Philadelphia College of Osteopathic Medicine entering September 1970 has been favorably acted upon by the Faculty Committee on Admissions and the Board of Directors. I congratulate you upon your acceptance. You have now taken the first step of your career in osteopathic medicine. In doing so you have assumed certain responsibilities. First, of course, is the fact that your personal and professional life must reflect the highest standards of moral integrity, intellectual effort, social consciousness, and professional dedication. Your immediate responsibility is that of maintaining a high level of academic accomplishment. Should you, for whatever reason, fail to maintain high standards in all these areas your acceptance will be automatically withdrawn. On or before April 27, a non-refundable tuition prepayment of $100 must be received by this office, in order to confirm your acceptance of a place in the Class of 1974. This payment of $100 will be applicable to your tuition payment for the Fall Term of 1970. You are now about to prepare yourself for a career of public service and public trust as an osteopathic physician. No career can bring you more satisfaction. My congratulations to you. We look forward to welcoming you in September. Very truly yours, Thomas M. Rowland, Jr. Vice President Director of Admissions