Physician Assistant Program
The University of Wisconsin-La Crosse – Gundersen – Mayo Physician Assistant
Program requires applicants submit a non-refundable program application fee of $50 by
the August 1 application deadline. Acceptable forms of payment include check, money
order and cash. An online payment option is not available. Please make checks and
money orders out to “University of Wisconsin-La Crosse” and direct payments to the
following address:
UW-L PA Program
1725 State St.
4033 HSC
La Crosse, WI 54601
Please complete the remainder of this form by typing responses directly into the fields
provided. Print the completed form and include with your non-refundable payment as
this will assure the payment is applied toward the correct application. Thank you.
Applicant’s Name:
Applicant’s CASPA ID:
Please submit fee only after beginning the CASPA process and the assignment of an ID.
UW-L ID (if applicable):
For those who have never attended UW-L please leave this space blank.
Failure to submit the non-refundable $50 fee by the August 1 application deadline will
result in an incomplete file.
EC:
