1603 West Taylor Street, Suite 1182
(MC 923)
Chicago, IL 60612-4394
312-996-6081
www.uic.edu/sph/
Bachelor of Arts in Public Health Application Checklist
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/transfer.html. Please note that international transfer
applicants must follow the international applicant instructions found in the UIC Transfer Application.
(2) 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
(3) Supplemental Application which includes the following:
a. Applicant Information Form
b. Prerequisite Self-Evaluation
c. Personal Statement
d. One Letter of Recommendation
e. Request for Prerequisite Exception (if necessary)
Supplemental application materials are available on the School of Public Health’s website and must be
submitted to the program at:
SPH Undergraduate Admissions Committee
1603 West Taylor Street, Suite 1182 (MC 923)
Chicago, IL 60612-4394
Current UIC students must submit:
(1) Official Transcripts: UIC students do not need to submit UIC transcripts. However, 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
(2) Supplemental Application which includes the following:
a. Applicant Information Form
b. Prerequisite Self-Evaluation
c. Personal Statement
d. One Letter of Recommendation
e. Request for Prerequisite Exception (if necessary)
Supplemental application materials are available on the School of Public Health’s website and must be
submitted to the program at:
SPH Undergraduate Admissions Committee
1603 West Taylor Street, Suite 1182 (MC 923)
Chicago, IL 60612-4394
Minimum Application Requirements:
(1) A cumulative GPA of 2.75 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) For fall 2012 admission only, the program will consider applicants who have not yet completed PUBH 110 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, Suite 1182
(MC 923)
Chicago, IL 60612-4394
312-996-6081
www.uic.edu/sph/
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, Suite 1182
(MC 923)
Chicago, IL 60612-4394
312-996-6081
www.uic.edu/sph/
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., 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.
eFor fall 2012 admission only, the 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.
g
List 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, Suite 1182
(MC 923)
Chicago, IL 60612-4394
312-996-6081
www.uic.edu/sph/
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
____________________
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, Suite 1182
(MC 923)
Chicago, IL 60612-4394
312-996-6081
www.uic.edu/sph/
Bachelor of Arts in Public Health Applicant Recommendation
The application for 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 referent to submit a
letter along with this form and mail both to the SPH Undergraduate Admissions Committee at the address above.
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, Suite 1182
(MC 923)
Chicago, IL 60612-4394
312-996-6081
www.uic.edu/sph/
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 (exception considered for fall 2012 admission only).
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:
__________________________