General Scholarship Application

2026-2027 WICHE PSEP Application

This application is for support that will begin Fall 2026.
APPLICATION REQUIREMENTS: Priority Deadline - October 15, 2025

Priority may be given to students who apply early. Late applications can be accepted and will be considered after those submitted on time.

Thank you for your interest in the Western Interstate Commission for Higher Education (WICHE) Professional Student Exchange Program (PSEP). Utah participates in the Optometry and Podiatry programs.

Please refer to the WICHE website for additional program details, including a listing of participating institutions. Admission requirements vary from institution to institution, but applying early is usually to your advantage. Submitting an application for WICHE PSEP support does not guarantee admission to an institution. Application to institutions that are not WICHE participants will have no bearing on your eligibility for certification.

Key Application Requirements
- To be considered, applicants must demonstrate Utah residency for at least the last 5 consecutive years prior to applying.
- You will need to submit the following documents when submitting this application:
  - A copy of your undergraduate transcripts;
  - A copy of your graduate transcripts (if currently enrolled);
  - A signed Consent Form (press the Ctrl button to open this link in another tab);
  - Documentation to demonstrate your 5+ years of Utah residency
Note - This application will need to be completed in one session. You will not be able to save your progress and return later. Before you start, please have all of the necessary information to complete the application.

A completed and approved application does not guarantee funding; state legislative appropriations determine the number of students the state can support each year.
Application for certification in *
Full Name*

First NameLast Name
Preferred Name
Date of Birth*

MonthDayYear
Please select all WICHE eligible colleges to which you're applying*

Midwestern University (Arizona College of Optometry)Marshall B. Ketchum University (Southern California College of Optometry)Western University of Health Sciences (College of Optometry)Pacific University (College of Optometry)
Please select all WICHE eligible colleges to which you're applying*

Midwestern University (Arizona Podiatric Medicine Program)Samuel Merritt University (California School of Podiatric Medicine)Western University of Health Sciences (College of Podiatric Medicine)
Gender
Completion of this question is voluntary. Sharing this information will not impact your eligibility to receive support.
Race/Ethnicity (may select multiple)
Completion of this question is voluntary. Completion of this question is voluntary. Sharing this information will not impact your eligibility to receive support.
Current Telephone Number*
Please enter a valid 10 digit phone number (beginning with the area code).
Email*
Enter E-mail Here
Current Address*

Street Address

Apt/Unit #

CityState

Zip Code
Is your permanent address different from you current address?*

YesNo
Permanent Address*

Street Address

Apt/Unit #

CityState

Zip Code
Previous addresses during the past five years*
If same as above, please indicate that here.
Current undergraduate overall GPA*
Complete list of high schools attended*
Complete list of colleges or universities attended*
I in major subject* at institution*.
I expect to complete/completed all requirements for admission to a school of * by Date* .
I have been a legal resident of state* since date*.
My parents have been legal residents of state* since date (month & year)*.
If you do not live in Utah, explain how you qualify as a Utah resident:
Acknowledgment and Signature

I expect to return to Utah to practice my profession if I participate in this program. I understand that continuation in the WICHE program is subject to legislative appropriations each year, and that I may be required to pay a portion of the WICHE or contract fee to the state as may be determined by the Legislature or the Utah State Board of Higher Education. I certify that all statements and dates herein are true to the best of my knowledge.
Signature*
Upload Consent Form*

Upload a File
Upload signed Consent Form here Cancelof
Upload College Transcript(s)*

Upload a File
Upload College Transcript(s) here Cancelof
Upload Residency Documentation*

Upload a File
Please submit at least 1 of the following: UT high school transcript confirming attendance (in addition to the college transcripts above); Utah driver's license or ID card showing it was issued 5+ years ago; vehicle registration for the last 5 years; evidence of employment in UT for 5+ years; proof of payment of UT resident income tax for 5+ years; rental agreements/utility bills for 5+ years. IMPORTANT: Additional documentation may be requested via email to supplement any documentation provided here. Cancelof
The State of Utah provides WICHE support for a limited number of students in the fields of Optometry and Podiatry. If you have questions regarding any part of this application, the requirements for this program, or would like additional information, please contact the Utah Certifying Officer, Cassidy Dragunat, via email cassidy.dragunat@ushe.edu or by telephone (801) 646-4812.
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2026-2027 WICHE PSEP Application

Acknowledgment and Signature