APPLICATION TO 3RD YEAR DIETETICS MAJOR, BSc (FNH) 2014 DEADLINE: January 31st, 2014 Student Name: Current Educational Institution: UBC (student number: ) Other (please specify) Preferred Email address for admissions correspondence: Phone: Is this your first application to the UBC Dietetics Major? Yes No, second Other (letter of permission is attached) Note: Only 2 applications are permitted unless written permission is given by the Dietetic Education Coordinator (if such permission has been granted, please attach copy of correspondence). Prerequisite Course Summary Please complete the table below. All applicants must have successfully completed at least 54 credits of university or college course work, including the courses listed (or their equivalent), by April 30, 2014. Please DO NOT enter grades in this area! Course UBC Educational Institution Other (provide institution name & course number) Completed In Progress ENGL 112 (3) BIOL 112 (3) BIOL 121 (3) BIOL 140 (2) CHEM 121, 123 (or 111, 113) (8) Social Science (6)1 (e.g. PSYC 100 (6), SOCI 100 (6) or equivalent) LFS 250 (6)1 LFS 252 (3)2 BIOL 200 (3) BIOL 201 (3) or BIOC 202 (3) CHEM 205, 233 (or CHEM 203, 213) (6) FNH 200 (3)1 FNH 250 (3) 1 Up To 9 credits of LFS 250 (6), FNH 200 (3), and Social Science (6) can be deferred until a student has been accepted into the Dietetics Major, as long as 54 credits of university or college course work including all other prerequisite courses have been completed. 2 Equivalent courses include BIOL 300, EPSE 482, FRST 231, STAT 200 533575291Form Page 1 of 2 Applicant Checklist Please read carefully and check off the pertinent points below prior to dating, printing and signing the form: 1. I have read the UBC Calendar entry for the Dietetics Major and the Applicant Information Package 2014 and am aware of admission criteria and selection procedures. 2. I am aware that in addition to submitting this application package, I am required to be accepted into UBC’s Bachelor of Science in Food, Nutrition, and Health program: a. I have already been accepted to this program. b. I will apply online to this program by January 31st, 2014. 3. I have enclosed all components of the application process in this package, including: a. This application form. b. Transcripts for prerequisite and any program courses completed outside of UBC. Note #1: If you are submitting interim transcripts, you must forward official final transcripts at the end of the current academic term. Note #2: If you are currently enrolled in a UBC degree program, you do not need to resubmit transcripts. c. Cover letter and resume prepared according to guidelines in the Applicant Information Package. d. Two confidential references (prepared using the provided form template according to guidelines in the Applicant Information Package) each submitted in a sealed envelope with your name on it (with sealed flap signed by referee). e. A cheque/money order for $50 (non-refundable, application fee), payable to UBC Faculty of Land & Food Systems. 4. All required documents (not including transcripts) have been printed single sided with no staples used. 5. Should I be accepted into the program, I am aware that I may be required to relocate within British Columbia for some or all of the final year to complete the internship component. 6. I am aware that if short-listed, I will need to be available for an in-person or telephone interview on May 1, 2014. Date ____________________________________________ Applicant Signature Send application package to: Student Services Office Faculty of Land & Food Systems 344-2357 Main Mall Vancouver, BC V6T 1Z4 NOTE: Application packages must be received at this location by the deadline of January 31, 2014. 533575291 Page 2 of 2