TEXAS SOUTHERN UNIVERSITY
COLLEGE OF PHARMACY & HEALTH SCIENCES
DEPARTMENT OF HEALTH SCIENCES
ENVIRONMENTAL HEALTH PROGRAM
(Applications are accepted year round)
GENERAL INFORMATION
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Place completed applications in a sealed envelope.
Entry level Environmental Health classes begin each fall semester. Students may enroll in the spring semester
under special circumstances and with the permission of the program director.
Applicant interviews are scheduled by appointment.
Transfer students must meet both the requirements for admission to the University and of the Environmental
Health Program.
APPLICATION DOCUMENTS AND SUBMISSION PROCESS
Environmental Health application
Official transcripts
Transcript evaluation
Typed narrative describing applicant background and interest in profession (maximum 2 pages)
3 Recommendations (use attached forms )
Place documents in a sealed legal size envelope and with your name and program on the outside.
Submit envelope containing all documents to Health Sciences main office NSC 202. You must verify your
submission by signature.
Applicants will be notified of application status by email or mail.
ENVIRONMENTAL HEALTH PROGRAM
PLEASE PRINT OR TYPE:
Name (Last)
_____________________
S.S./I D Number
(First)
_________________
Date of Birth
(Middle)
______________________
Cell Phone
________________________
Current Telephone
_____________________________________________________________________
E-Mail Address
________________________
Permanent Telephone
Current Address
City
State
Zip Code
Permanent Address
City
State
Zip Code
List Other colleges/universities you have attended:
Transfer Student:
______________ Yes
____________ No
College/University
City
State
Hrs.
Degree
College/University
City
State
Hrs.
Degree
Signature
Date
Applicant Signature _______________________________Date:_______________
Submit typed narrative (maximum 2 pages) and attach to application.
Texas Southern University
College of Pharmacy and Health Sciences
Environmental Health Program
Applicant Recommendation Form
(may be duplicated)
Applicant Name: _______________________________________________________________
TO THE RECOMMENDER: The above-named student has applied for admission to the Environmental Health Program. Someone
who has previously taught this student and has known the applicant for at least one-year period must complete this section. We
appreciate your frank appraisal of the student. Your recommendation may be given to the student in a sealed envelope or you may
mail it to: Texas Southern University College of Pharmacy and Health Sciences Environmental Health Program 3100 Cleburne
Houston, Texas 77004.
1. Please evaluate the applicant on following characteristics by checking the appropriate number. The applicant should be rated on a
scale of 1-10 (with “1” representing the lowest rating, and “10” representing the highest rating. If you are unable to rate a
particular characteristic, please enter “NA” which will indicate unknown.
Please attach a letter of recommendation as desired.
CHARACTERISTIC
1
2
3
4
5
6
7
8
9
Personal Appearance
Academic Ability
Self-Confidence
Work Habits
Motivation Towards Program
Seriousness of Purpose
Potential for Contribution /
Commitment to Profession
(enthusiasm professional demeanor
knowledge level)
Resourcefulness and Initiative
(self starter, work habits, followthrough, ability to work
independently)
Maturity( self control emotional
stability acceptance of constructive
criticism)
Adaptability
Communication skills
oral
written
listening
Teamwork (ability to work with others,
cooperative disposition)
Reliability (promptness,
conscientiousness, dependability)
Integrity (moral character, honesty)
Leadership skills (ability to inspire
confidence)
Intellectual curiosity ( interest in learning,
active, learner, creative thought)
Empathy (sensitivity to needs of others,
caring attitude toward others)
How long have you known this applicant? _________________________
1.
In what capacity have you known the applicant? _____________________
Your best estimate of the applicant’s overall potential for success in the Environmental Health Program.
______Poor _______Below Average ______Good _____Outstanding
Additional Comments:
2.
Recommender’s Printed Name___________________________________
Recommender’s Signature____________________________________Date_______________________
10
Recommender’s Title and Employer _____________Employer ______________________________
Department of Health Sciences Application Checklist
APPLICANT PROCESSING CHECK LIST
PROGRAM:__________________________________
SEMESTER: _________________________________
LAST NAME: __________________FIRST NAME___________________
T-NUMBER:__________________________________
Transcripts Included check:
YES
NO
COMMENTS:
Complete Incomplete
APPLICATION
LETTERS OF
RECOMMENDATION (3)
ESSAY
GPA
TRANSCRIPTS
TRANSCRIPTEVALUATION