Page |1 Admission Requirements Requirements for admission to the certificate program are identical to those for the master’s degrees in the affiliated departments, equivalent to the MS in industrial engineering or the MHA in health policy management. MHA applicants can also apply for the certificate through the online centralized application service, SOPHAS (www.sophas.org). Students already enrolled in the Graduate School of Public Health may apply by contacting the Office of Student Affairs at stuaff@pitt.edu. Students already enrolled in the Industrial Engineering Department should contact the Graduate Program Director at gradie@pitt.edu. Certificate admission may be initiated at any time after the applicant has been admitted to the affiliated degree programs. If you are a student in the Department of Health Policy & Management, please fill out the application below: Health Policy & Management Department – Return to A668 Crabtree Hall Pittsburgh, PA 15261 and to The Office of Student Affairs – 114 Parran Hall Pittsburgh, PA 15261 Industrial Engineering Department – Return to 1048 Benedum Hall Pittsburgh, PA 15261 Page |2 Application for Admission Graduate Certificate in Health Systems Engineering Name: (First, Last) Local Address: Home Address: City: Mobile Phone: State: Zip Code: Home Phone: Pitt E-Mail Address: Current Academic Program: School: Degree: People Soft Number: Expected Date of Graduation: Student Signature: Date: Advisor Signature: Date: Health Policy & Management Department – Return to A668 Crabtree Hall Pittsburgh, PA 15261 and to The Office of Student Affairs – 114 Parran Hall Pittsburgh, PA 15261 Industrial Engineering Department – Return to 1048 Benedum Hall Pittsburgh, PA 15261 Page |3 Please write a brief statement explaining specifically how the Health Systems Engineering Certificate would further your career goals: Health Policy & Management Department – Return to A668 Crabtree Hall Pittsburgh, PA 15261 and to The Office of Student Affairs – 114 Parran Hall Pittsburgh, PA 15261 Industrial Engineering Department – Return to 1048 Benedum Hall Pittsburgh, PA 15261