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Application Requirements

Florida Department of Health in Pasco County

The following documents must be submitted by the following deadlines:

  • Pre-Select Candidates: September 1st – November 1st
  • Computer Matching Candidates: February 15th

  

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Required documents for application to the WIC and PAL Tracks:

  • Signed Application Checklist
  • Completed Application
  • Official “Verification Statement of Completion” or “Declaration of Intent to Complete” form from an accredited Didactic Program in Dietetics (DPD)
  • One official sealed transcript per institution attended   
  • Three Academy Waiver and Recommendation forms (one is required from a current supervisor and two are chosen from the following three options):
    1. former supervisor
    2. instructor/professor
    3. professional mentor
  • Letter of Intent that addresses (limit to one typed page, 12 pt. Times New Roman font, single spaced):
    • The reason for entering dietetics
    • Short- and long-term goals
    • Personal strengths and areas for improvement
    • Attributes important for candidate selection
    • Reason why you are applying to our public health program
    • Your expectations from our program 

 Additional Requirements for the WIC Track:

  • Signed WIC Eligibility Statement (Pre-Select only)
  • Completed Regional Site and Status Selection form 
  • A $50 non-refundable application processing fee (Make check or money order payable to Florida Department of Health in Pasco County.)

 Additional Requirements for the PAL Track:

  • A $250 non-refundable application processing fee (Make check or money order payable to Florida Department of Health in Pasco County.)

 

   Application Forms  

 
 

Pre-Select Forms

Application Checklist (PDF 112 KB)

Application (PDF 169 KB)

WIC Eligibility Statement (PDF 175 KB)

Waiver and Recommendation Form (PDF 77 KB)

Regional Site and Status Selections (PDF 284 KB)

 

Matching Forms

Application Checklist - Matching PAL Track

Application Checklist - Matching WIC Track

Application Process - Pasco County

Regional Site Selection - Matching WIC Track