Verification of Commitment (Sample)

During the Application Process, you will be asked to complete and sign this form.

APPLICANT’S VERIFICATION OF COMMITMENT

My application for admission to the Boise State University Master of Science in Genetic Counseling (“MSGC”) degree program is complete and accurate.

• I am able and willing to participate in the second year of fieldwork as described which will likely include travel outside of my permanent residence
• Pledge the required hours (suggested 30 hours per week) to actively engage in the program as a full time student

Although the program will minimize expenses, the costs associated with the fieldwork rotations
are not covered by tuition and will be my responsibility.

I understand that an incomplete or inaccurate statement or representation in any of my application materials may result in denial or revocation of my admission to the MSGC program, or if discovered after my admission, may result in my dismissal from the MSGC program.

Applicant’s Signature: __(Electronic Signature)_______________________

Date: _________________________________

Transact Reference Number MSGC Program fee receipt:__(Number on the Program Application Fee Receipt)__

National Match Number:_____________________________