SBS PhD Admission Form by 3e6gVny

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									                                          APPLICATION FOR ADMISSION TO
                      PhD Program in Social and Behavioral Sciences (SBS), School of Public Health
                                            THE UNIVERSITY OF MEMPHIS
                        (In addition to the PhD program, applicants must apply to the U of M Graduate School).
                                        http://www.memphis.edu/gradschool/admproc.php



BIOGRAPHICAL AND ACADEMIC INFORMATION
Last Name                                            First Name                                    M.I.

Street Address                                                                                     Apartment #

City                                                 State                                         Zip

Home Phone                                                            Work Phone

Cell Phone                                                            Email Address

Date of Application

Applying for (Check One)                          Part-Time                 Full-Time

Semester and Year Applying For (Check One)        Spring 20___               Fall 20___

Applying for Assistantship (Check One)             Yes                        No


EDUCATIONAL HISTORY
Please list all graduate and undergraduate programs attended.
                                                              Degrees                                    Graduated          Cumulative
        Institution Attended             From      To                            Major/Minor
                                                              Earned                                      (Yes/No)            GPA
                                                                                                         Yes     No
                                                                                                         Yes     No
                                                                                                         Yes     No
                                                                                                         Yes     No
                                                                                                         Yes     No


WORK HISTORY
                           Company Name                                   From          To                  Position Held




Statement of Purpose
Applicants must also submit a personal statement of approximately 750 to 1000 words indicating his/her present interests and career
goals, including how the PhD in Social and Behavioral Sciences will prepare the candidate to achieve these goals.
Reference Letters
Letters of recommendation from three individuals (at least two letters from former professors or instructors) familiar with the
applicant’s academic background or experience in public health related work, specifying in detail the applicant’s capabilities for
graduate study and for future performance as a public health scholar, are required.
REFERENCES
Please list 3 professional references

                                                                  1
            Full Name                         Place of Work                     Email address                      Phone Number




TEST SCORES

GRE Scores              Verbal                                 Quantitative                           Writing

Is English your primary language?                                  YES                          NO

If Not, TOEFL Score

Other Test Scores,
(MCAT, GMAT,
LSAT, DAT, etc.)
    I would like to be considered for Graduate Assistantship (Note: only full-time students are eligible for GA awards.
    Awards are limited and are determined on a competitive basis.)


Application deadline is March 1st.
Application Checklist:
Materials sent to the SBS Division:
  Application to the School of Public Health (attached);
  Statement of Purpose (750 – 1,000 words);
  Names and contact information of three references (at least two from former or current faculty members). Please use
  the Reference Letter Form (attached);
  Curriculum Vitae;
  Copies of transcripts from all institutions of higher education attended (Official transcripts should be submitted to the
  UofM Graduate School); and
  Copy of GRE scores (Official copy should be submitted to the UofM Graduate School)
Materials sent to the UofM Graduate School:
   Application to the University of Memphis Graduate School;
   $35 application fee;
   Official transcripts from all institutions of higher education attended; and
   Official GRE scores.

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to admission, I understand that false or misleading information in my application may result in cancellation of
admission.

Signature                                                                                         Date
Please return this form along with the recommendation letter via postal mail to:

            Shirl Sharpe
            Academic Service Coordinator
            Division of Social and Behavioral Sciences
            School of Public Health
            The University of Memphis
            114 Robison Hall
            Memphis, TN 38152

            Email: ssharpe@memphis.edu; Phone: (901) 678-1710; Fax: (901) 678-0172


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