Checklist of Required Documents for Application to the
Transitional Doctor of Physical Therapy (t-DPT) Program
Print Form
This checklist is provided to help you ensure your application to the Transitional Doctor of Physical Therapy program at Governors State
University is complete. Please go over the list of required documents and information, and check the box next to the name of each
document, to confirm that you are including it in your application package. Please note, this checklist form is also a required application
document. You must include it with your other application materials. We will use this form to ensure your application is complete.
Last Name
First Name
Applicant's Document Check Boxes
Initial
For Office Use Only
Doctoral Application - Transitional Doctor of Physical Therapy Program
Copy of Current Physical Therapy License
Received
Received
Missing
Missing
Two Recommendation Forms
Official College Transcripts for All Schools Attended
Received
Received
Missing
Missing
t-DPT Essay Form
Received
Missing
Educational Credentials Evaluation (ECE) for internationally educated physical
therapists
Received
Missing
Test of English as a Second Language scores for physical therapists educated in a
language other than English.
Received
Missing
Self-Addressed Stamped Envelope
$75.00 Non-Refundable Application Fee
Not Applicable
Copy of Clinical Specialist Award
Received
Received
Received
Missing
Missing
Missing
Please list schools from which you have included transcripts