MIDWESTERN STATE UNIVERSITY
Health and Public Administration
College of Health Sciences and Human Services
3410 Taft Boulevard Martin Hall 107 Wichita Falls, Texas 76308-2099
Office: 940-397-4752
Dear Health Administrator or Potential Health Administrator:
The Administration, Faculty and Staff of Midwestern State University warmly welcomes your interest in our Health
Services Administration (HSAD) programs. You will find enclosed information on our MHA, and Graduate
Certificate in Health Services Administration (GCHSA).
Also enclosed are the MSU and HSAD application materials. On the MSU application and for those of you
who are applying for the MHA, please type in MHA on the major question #13. All others, please follow the
codes as indicated on the back of the MSU application.
If you are interested in enrolling for the upcoming semester, please return the MSU and HSAD applications
as soon as possible. All applications must be complete before students may be admitted to the program. We
encourage you to apply quickly to reserve a space.
If you have any questions about our HSAD programs or difficulties in the application process, please feel free
to contact me personally at (940) 397-4671. For general questions, you may contact Mrs. Sue Cook at (940)3974752 or email at sue.cook@mwsu.edu.
We are excited about helping your academic and health services administration career!
Sincerely,
Nathan R. Moran, Ph.D.
Chair – Health and Public Administration
Associate Professor – College of Health and Human Services
Midwestern State University
College of Health Sciences
Health Services Administration Graduate Programs Application
(MHA; GCHSA)
Please type or print in ink
You must also complete an MSU application and respective
MBA, MSN or MPA application for admission to those programs
1. Application Classification
New Student:
Readmission:
Auditing:
2. Program Seeking
| | MHA:
|
| | GCHSA:
|
/
| | Fall
| | Spring
3. Projected Entrance
| 20
| 20
/
4. Date of Application:
5. Student ID:
M
Month Day Year
6. Name:
Last
Current Mailing
Address:
(Prefix) First
M.I.
Maiden (if applicable)
City
State
Country // Zip Code
State
Country // Zip Code
Street
Home Phone Number:
Work Phone:
Cell Number:
Email:
7. Permanent
Address:
Street
(If different than current address)
City
8. Indicate your score for one of the following if available:
a) Scores on GRE:
Verbal
b) Scores on GMAT:
Verbal
(
)
(
)
Quantitative
(
)
Quantitative
(
)
Analytical
Total
(
(
)
)
Analytical
(
If you have not taken an exam, please indicate the date which you expect to take it.
The GRE is preferred, but GMAT scores are accepted.
9. Date of GRE
Or GMAT
(check which applies)
10. Current Academic/Professional Degrees:
(Check all that apply)
Test if not taken:
Month
B.A./B.S.
M.A./M.S.
Day
M.D./J.D.
Year
Ph.D./Ed.D.
)
11. List ALL colleges and universities you have attended in chronological order. (Including those where you did not
graduate)
Use an additional sheet of paper, if required. One official transcript from each institution must be sent directly to the
Office of the Registrar.
College/University Attended
Attendance Dates
From
To
Degree
Major
12. List ALL Employers or Military Service in chronological order. Use an additional sheet of paper, if required.
Employer
Employment Dates
From
To
Position
Major Duty
13. List Professional and Community Affiliations, Offices Held, Committees, Positions
14. Please describe the top five (5) professional goals you hope to achieve by pursuing your health
administration degree:
1.
2.
3.
4.
5.
15. List the names and addresses of three individuals who you will ask to provide references for the HSA program.
It is recommended that at least one reference be from an educator familiar with your academic performance.
1. Name:
Address:
2. Name
Address:
3. Name
Address:
I certify that the information in this application is complete and correct to the best of my knowledge and belief, and
understand that submission of any false information or incomplete information is grounds for rejection of my
application, withdrawal of any offer of acceptance, or dismissal after enrollment.
Signature
Date
Email completed Application to: sue.cook@mwsu.edu
Sue Cook
Health and Public Administration
Midwestern State University
3410 Taft Blvd.
Wichita Falls, Texas 76308
Thank You for the information, we are excited about your interest in our HSA programs!!
Midwestern State University
Department of Public and Health Administration
Scholarship and Graduate Assistantship Application
Eligibility: Please check to insure that you meet the requirements stated for the scholarship(s) and/or
graduate assistantship for which you are applying.
Additional Requirements: If you are applying for a department based scholarship please attach your
resume and a short essay indicating how the scholarship you are applying for will help you obtain your
academic and career goals and why you believe you are qualified for the position. Please be sure to
briefly review your academic qualifications and any unusual financial situations you are experiencing in
your essay. Students selected for the Minnie Rae Wood scholarship must write a thank you letter to the
scholarship committee.
If you are applying for the graduate assistantship attach your current resume and a cover letter stating
what academic, computer or research skills you have to offer the department. Students applying for the
assistantship will also be interviewed by the scholarship committee prior to it being awarded.
Please place a check next to the scholarship being applied for:
Minnie Rae Wood (Fulltime MHA or MSN only)
Graduate Scholarship (Fulltime students only)
If you have received a departmental scholarship previously please indicate which
scholarship(s) and in what years you received it.
Scholarship Name
Year 1
Year 2
Scholarship Name
Year 1
Year 2
Please check here if applying for the Graduate Assistantship
Name:
Last
First
Middle
Home
Address:
Street
City, State Zip Code
Country
Street
City
State, Zip Code
Local Address:
(If different)
Student ID
M
Phone #
Social Security Number:
Email
Degree: MPA
MHA
Statement: Applicants for the graduate assistantship and the scholarships understand that selection is competitive
and determinations made by the department scholarship committee are final.
____________________________________
Student Signature
________________
Date