PhD Epidemiology Program Checklist
(to be completed by the applicant and returned with the application form)
Degree Conferral Information for:
______________________
family name |
______________________
first name |
____ Master’s degree from ___________________________________________
____ GPA on _____ hours
Major: __________________________________
____ Baccalaureate degree from ___________________________________________
____ GPA on _____ hours
Major: __________________________________
| Other colleges/universities attended |
Major |
Years |
GPA |
Hours |
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
Recommended Course Work
A. Two semesters of biological sciences:
| List course # & title |
College/University |
Credit Hours |
Grade |
Years |
| |
|
|
|
|
| |
|
|
|
|
B. Math through Calculus:
| List course # & title |
College/University |
Credit Hours |
Grade |
Years |
| |
|
|
|
|
| |
|
|
|
|
Other Knowledge Experience
Do you have public and/or health provider experience or training? __
Yes __ No
Do you have computer experience?__ Yes __ No
If yes, using what software package?_________________________________________________
Circle Your Interest Areas
| Aging |
Clinical |
Injury |
Nutrition |
| Birth Defects |
Genetics |
International Health |
Pharmacoepidemiology |
| Cancer |
Hospital |
Intervention & Clinical Trials |
Reproductive/Women’s Health |
| Cardiovascular |
Infectious Disease |
Neurological Methods |
Communication Disorders |
| Health Services Evaluation |
Quantitative. Analytic Methods |
Public Health Practice |
|
|
