Contingent Admit Program Application

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The Contingent Admit Program (CAP) was designed for exceptional high school seniors who are considering a
career in pharmacy. This unique opportunity gives students a head start on their professional education.

CAP is open to rising college freshmen, who have a cumulative grade point average (GPA) of 3.30 or higher. To be eligible for this program, students must meet the following criteria:

Minimum cumulative high school GPA of 3.3 on 4.0 scale.
A personal statement of interest
One letter of reference
Submission of the Xavier University of Louisiana admission application

Basic Information

First Name

Middle Name:

Last Name

Suffix

Please select the option that best describes the student:

Please select the student's t-shirt size below:

Start Term

Xavier Student Number:

900 Number

Birthdate

Check one or more that best describes your race:

Are you Hispanic?

Yes

Are you the dependent of a Veteran or active U.S. Military Service member?

None

Current Dependent

Currently Serving

Not US Citizen? If not, please select country.

Student Email Address (use xula email address):

Mailing Address

Country

Street

City

Region

Postal Code

Educational Information

Current Grade Level

Mathematics or Science Instructor Recommendation

Please provide contact information for a mathematics or science instructor who can provide a letter of recommendation on your behalf.

Evaluator (1) First Name:

Evaluator (1) Last Name:

Evaluator (2) Last Name:

Please upload the letter of recommendation here: (The recommendation must be signed and dated.):

Emergency Contact

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

Upload Additional Requirements

All Contingent Admit Program applicants are required to submit a statement of interest in the program.

Upload a maximum 500 word "Statement of Interest" detailing why you want to be a part of CAP as well as your motivation and professional aspirations of being in the Health Care profession.

Contingent Admit Program Application

COMMUNICATION

CAMPUS

INFORMATION

PEOPLE