1603 West Taylor Street, Room 1113 Chicago, IL 60612-4394 312-355-2536 www.publichealth.uic.edu Bachelor of Arts in Public Health Application Checklist Current UIC students must submit: (1) Application which includes the following: a. Applicant Information Form b. Resume addressing employment history and volunteer/service activities c. Prerequisite Self-Evaluation d. Personal Statement e. One Letter of Recommendation f. Request for Prerequisite Exception (if necessary) Application information and forms are available on the School of Public Health’s website (www.publichealth.uic.edu/admissions) and must be submitted to the program at: SPH Undergraduate Admissions Committee 1603 West Taylor Street, Room 1113 (MC 923) Chicago, IL 60612-4394 (2) Academic History/Transcripts: UIC students should print their UIC Academic History available online via www.my.UIC.edu and include this information with their application materials. In addition, official sealed transcripts from all other colleges and universities attended since matriculating to UIC are to be submitted to: UIC Office of Admissions and Records (MC 018) Box 5220 Chicago, IL 60680-5220 Students applying from other colleges or universities must submit: (1) Completed UIC Transfer Application: This online application requires a $50.00 application fee. You can access the application here: www.uic.edu/depts/oar/undergrad/apply_undergrad.html. (2) Personal Statement: Applicants should be sure include a statement addressing their desire to pursue the public health major as part of the Program Choice Personal Statement prompt in the online Transfer Application. Include in the statement the life experiences, activities, and academic work that have prepared you to pursue a baccalaureate degree in public health. (3) Supplemental Application Materials which includes the following: a. Resume addressing employment history and volunteer/service activities b. Prerequisite Self-Evaluation c. One Letter of Recommendation Supplemental application information and forms are available on the School of Public Health’s website (www.publichealth.uic.edu/admissions) and should be uploaded into the online application system. (4) Official Transcripts: Official sealed transcripts from all colleges and universities attended are to be submitted to: UIC Office of Admissions and Records (MC 018) Box 5220 Chicago, IL 60680-5220 Minimum Application Requirements: (1) Successful candidates will typically have a cumulative GPA of 2.75/4.00 or higher. (2) Evidence of successful completion or pending completion before matriculation of the minimum 60 semester hours of general education course work outlined on the Prerequisite Self-Evaluation Form. This course work reflects the completion of PUBH 100, 110, 120 or equivalent courses* with grades of B or higher. (3) The program will consider applicants who have not yet completed PUBH 110 or their full foreign language sequence who submit a written Request for Prerequisite Exception with their application. *To determine if a course is an equivalent, the student must submit a course syllabus for review by the Curriculum Committee well in advance of the application deadline. 1603 West Taylor Street, Room 1113 Chicago, IL 60612-4394 312-355-2536 www.publichealth.uic.edu Bachelor of Arts in Public Health Applicant Information Form Please type the information below and sign and date the second page of this form. Submit this form along with all other required application materials to the SPH Undergraduate Admissions Committee at the address above. Date Completed: Desired Admission Term: Fall of Year ________________________________________ ____________________________ _______________ Last Name (Family, Surname) First (Given) Middle ______________________ Date of Birth ______________________ UIN ___________________________________________________________________ _____________________ Current Mailing Address: Number and Street Apt No. ___________________________ City ___________________________________ _____________________ State Zip Code ___________________________________________________________________ _____________________ Permanent Mailing Address: Number and Street Apt No. ___________________________ City ___________________________________ _____________________ State Zip Code ___________________________ ___________________________________ _____________________ Home Phone Cell Phone E-mail Address The BA in Public Health offers two tracks: Professional track - designed for those students who intend to enter the professional workforce upon completion of the BA. Academic track - designed for those students who intend to pursue further academic degrees upon completion of the BA. Please indicate the track to which you are applying: Are you presently enrolled at UIC? Yes Professional Track No If yes, indicate your current College: Are you presently applying for admission to any other programs at UIC? If yes, indicate the program(s): Academic Track Yes Undecided ________________________ No ____________________________________________________________________ Have you applied to the BA in Public Health program previously? If yes, indicate your previous application term and year: Yes No ________________________ Colleges or Universities Attended (list all beginning with current or most recent college/university attended) College or University City and State From To Degrees Conferred or Hours Earned 1. 2. 3. 4. 5. Employment Experience (list all beginning with current or most recent employer) Employer City and State From 1. To Hours Per Week To Hours Per Week 2. 3. 4. 5. 6. Volunteer Experience (list all beginning with current or most recent organization) Organization City and State From 1. 2. 3. 4. 5. 1. List the name of the individual who is providing a letter of recommendation: ______________________________ I understand that withholding information requested on this application, including attendance at any other institution or providing false information, may make me ineligible for admission to the University/Program or subject to dismissal if admitted. I have read and understand all instructions and information on this application and certify that the information provided is complete and accurate to the best of my knowledge. Signature: ________________________________________________ Date: __________________________ 1603 West Taylor Street, Room 1113 Chicago, IL 60612-4394 312-355-2536 www.publichealth.uic.edu Bachelor of Arts in Public Health Applicant Prerequisite Self-Evaluation _____________________ _____________________ __________ Last Name (Family, Surname) First (Given) Middle _____________________ UIN Please type the courses below that you have completed and/or intend to complete. If you have repeated a course, you must provide the required information for all attempts at the course. Attach an additional sheet if necessary. If you change your projected course work, please notify the BA in Public Health program in writing at the above address. Please note that listing a course on this form does not guarantee that it satisfies a prerequisite. Prerequisite School Attended Course Dept. Grade Credit Term Term & Number Earned Hours Completed Planned English Comp I English Comp II Foreign Language Ia Foreign Language IIa Foreign Language IIIa Foreign Language IVa Quantitative Reasoningb PUBH 100c PUBH 110d,e PUBH 120 Natural World with Lab Life Science (e.g., ANTH 105, BIOS 100, 101, or 104 at UIC) Understanding the Individual and Societyf Understanding US Societyf Exploring World Culturesf Understanding the Pastf Understanding the Creative Artsf Additional Gen Ed from any categoryf Note: As necessary to total 24 hours of Gen Ed credit Electiveg Electiveg Electiveg Electiveg Total Credit Hours Earned/ Planned aIf a student has a background in a foreign language, proficiency in that language will be determined by testing. Should a student be deemed proficient, other course work will be chosen for this credit hour requirement. See the College of Liberal Arts and Sciences foreign language requirement in the Undergraduate Catalog for further explanation. Please note that one or two remaining semesters of foreign language may be completed upon matriculation to the major provided the student submits a written Request for Prerequisite Exception with their application. b Students may choose from the following courses at UIC: MATH 121, 123, 145, 160, 165, 180; PHIL 102 or 210; STAT 101; COMM 201; CLJ 262; POLS 201; PSCH 343; and SOC 201. See the BA in Public Health undergraduate catalog statement for more information. CPUBH 100 may also be used to satisfy the Individual and Society or US Society General Education category listed above. dPUBH 110 may also be used to satisfy the Individual and Society or World Cultures General Education category listed above. eThe program will consider applicants who have not yet completed PUBH 110 provided the student submits a written Request for Prerequisite Exception with their application. fStudents should consult the General Education section of the Undergraduate Catalog for a list of approved courses in this category. gList the elective courses you have completed/will complete to reach the minimum of 60 semester hours. Attach an additional page if necessary. 1603 West Taylor Street, Room 1113 Chicago, IL 60612-4394 312-355-2536 www.publichealth.uic.edu Bachelor of Arts in Public Health Applicant Personal Statement Please use this form to submit your typed personal statement. You may add 1 additional page. Maximum statement length is two pages, double spaced, in 12 pt. font. Public health has been defined as “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations-public and private, communities and individuals”.1 The baccalaureate program in public health was designed to accommodate students with an array of career aspirations not limited to but including public health. Please tell us how your career goals and personal aspirations fit with the above definition of public health. We would like to know why you are selecting public health as an undergraduate major. Include in your statement the life experiences, activities, and academic work that have prepared you to pursue a baccalaureate degree in public health. ___________________________ _______________ __________ Last Name (Family, Surname) First (Given) Middle 1 ____________________ UIN Winslow, Charles-Edward Amory (1920 Jan 9). "The Untilled Fields of Public Health". Science 51 (1306): 23–33. doi:10.1126/science.51.1306.23. PMID 17838891. 1603 West Taylor Street, Room 1113 Chicago, IL 60612-4394 312-355-2536 www.publichealth.uic.edu Bachelor of Arts in Public Health Applicant Recommendation The application to the BA in Public Health requires one letter of recommendation from someone who can speak to your suitability to pursue and complete a baccalaureate degree in public health. This recommendation may be from a professional or academic reference (i.e., work or volunteer supervisor, course instructor, advisor, etc.). Recommendations from friends or relatives are not permitted and will be disregarded. Ask your recommender to submit a letter along with this form and mail both to the SPH Undergraduate Admissions Committee at the address above. Your recommender may also return the recommendation directly to you to submit with your other supplemental application materials provided that the recommender places the recommendation in a sealed envelope and signs across the seal. To be completed by applicant: Please print or type the information below: _______________________________ ____________ _________ Applicant Last Name (Family, Surname) First (Given) Middle _____________________ UIN __________________________________ __________________________________ _______________ Applicant Home Phone Cell Phone E-mail Address Release of access to this letter of recommendation: The applicant must complete and sign the following statement prior to submitting this form to the recommender. I understand that I may, though am not required to, waive my rights to inspect this letter of recommendation. As such, I waive my right of access to this letter of recommendation. I do not waive my right of access to this letter of recommendation. ________________________________________________________________ Applicant’s Signature ____________________ Date To be completed by recommender: The person named above is applying for admission to the Bachelor of Arts in Public Health program at the University of Illinois at Chicago School of Public Health. We would appreciate your candid assessment of the applicant’s suitability for our program. Please attach this completed form to your letter of recommendation and return it in a signed, sealed envelope to the SPH Undergraduate Admissions Committee at the address provided above. You may also return the recommendation directly to the applicant to submit with his or her other supplemental application materials provided that you have put the recommendation in a sealed envelope and have signed across the seal. How long have you know the applicant? ____________________________________________________________ In what capacity have you known the applicant (supervisor, instructor, advisor, etc.)? _______________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Please rate the applicant on the following attributes: Attribute 1 (Questionable) 2 (Satisfactory) 3 (Outstanding) U (Unknown) Academic Skills Written Communication Skills Verbal Communication Skills Capacity to Form and Sustain Collegial Relationships Judgment Conduct Comments or examples to supplement above ratings: If you wish to elaborate on any of your responses, please provide any additional remarks below. Name of person completing this form: Position or Title: Business Address: Phone Number: ______________________________________________________________ _____________________________ Institution/Organization: _ ______________________ ______________________________________________________________________ ________ _____________________________ E-mail Address: Signature: _______________________________________ Date: ___ ____________________________ _______________________________________ 1603 West Taylor Street, Room 1113 Chicago, IL 60612-4394 312-355-2536 www.publichealth.uic.edu Bachelor of Arts in Public Health Request for Prerequisite Exception Application to the Bachelor of Arts in Public Health requires evidence of successful completion or pending completion before matriculation of the minimum 60 semester hours of general education course work outlined on the Prerequisite Self-Evaluation Form. The program will consider written requests for exceptions to our prerequisite course work requirements for the following situations only: Students who still need to complete one or two semesters of foreign language but will still have earned 60 total semester hours by matriculation to the major; Students who still need to complete PUBH 110: Public Health and Global Societies but will still have earned 60 total semester hours by matriculation to the major. Granting of a prerequisite exception does NOT waive the student from completing the prerequisite in question; it merely permits the student to complete the prerequisite after admission to the public health major. Therefore, students must be able to demonstrate that they will be able to complete the remaining prerequisite course work once admitted to the public health major. To be considered for a prerequisite exception, please provide the information below and submit this form with your other supplemental application materials. ___________________________ _______________ __________ Last Name (Family, Surname) First (Given) Middle Course Prerequisites Not Completed By Term of Admission College or University Where Course City and State Will Be Completed ____________________ UIN Term of Intended Enrollment 1. 2. 3. Please explain why you were unable to complete the course(s) above and how you plan to be able to fit the course or courses in with your public health major course work if admitted to the major: _____________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ By signing below I acknowledge that if admitted to the public health major, I will need to complete the missing prerequisites above along with all the required major course work and requirements in order to earn a Bachelor of Arts in Public Health. Signature: ________________________________________________ Date: __________________________