Colorado School of Public Health

Certificate Programs

Admissions Instructions and Requirements

Submission Deadlines:

Please see current deadlines posted on the CSPH website.

Application Requirements – Required of all applicants:

  • Completed certificate application form
  • One official copy of all academic transcripts, sent directly from the University Registrar to the CSPHAdmissions Specialist (see address below)
  • One letter of recommendation sent via email as an attachment to from a professor, supervisor, or an individual qualified to comment on past performance and ability to perform graduate work
  • Resume or CV, sent via email as an attachment to .
  • A $50 non-refundable application fee (check or money order) made out to the Colorado School of Public Health. Applications will not be processed without the application fee.

International Student Additional Requirements

  • Evaluation of official transcripts through World Education Services (WES):
  • Official TOEFL test scores, sent directly to the University of Colorado Denver, ETS ID 4877.
  • Proof of funding for tuition, fees and living expenses
  • Completed I-20 request form

Submit official transcripts and application fee payment via mail to:

CSPH Admissions Specialist

Colorado School of Public Health

13001 East 17th Place

Campus Box B119

Aurora, CO 80045

Phone: 303.724.4613

Fax: 303.724.4620

Submit application via email to:

Please type the following into the subject line: “CPHS App Last Name_First Initial”
Application may be sent via mail to the above mailing address. Email submission is strongly preferred.

Colorado School of Public Health

Certificate Program

Admissions Application

I. APPLICANT DATA

Select the certificate program to which you are applying (please choose only one certificate program):

Certificate in Public Health Sciences,University of Colorado Denver Campus

Certificate in Public Health Science, University of Northern Colorado Campus

Certificate in Global Public Health, University of Colorado Denver Campus

Semester to which you are applying (spring or summer only): Year of Application:

Last Name: First Name: MI:

Maiden Name: Social Security Number:

Email Address: Univ. of Colorado ID (if applicable)

Mailing Address:

City: State: Zip:

Home Phone: Cell Phone:

Gender: M F Ethnicity (not required):

Birth Date (mm/dd/yyyy): Place of Birth:

Country of Citizenship:

In case of emergency, notify: Relationship:

Address: Phone:

Languages: List any foreign languages you speak and indicate the degree of proficiency.

Residents of Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming are eligible to enroll in the CSPH Certificate programs at resident tuition rates through the Western Regional Graduate Program. Proof of residency will be required. If you are from an eligible state (as listed above), are you applying for WRGP funding?

International Students Only:

If not a US citizen, check Visa type below:

Student F-1 Exchange Visitor J-1 Immigrant Other

Non US Citizen on Permanent Status: Alien Registration #:

TOEFL Score (official scores must be sent to UC Denver, ETS ID 4877) Date Taken (mm/dd/yy):

Financial Statement Submitted: Yes No

II. EDUCATION

Undergraduate:

(1)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

Undergraduate, cont:

(2)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

(3)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

(4)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

Graduate (if applicable):

(1)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

(2)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

Doctorate, if applicable:

(1)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

(2)Name of College/University (please type out full name):

Dates of Attendance (mm/yy to mm/yy): to Major:

Degree Earned: GPA:

Have you applied to the Colorado School of Public Health Certificate program in the past?

Have you applied to the Colorado School of Public Health MPH program in the past?

Do you plan to apply to the Master of Public Health degree upon completion of the certificate?

Have you taken any Colorado School of Public Health classes as a non-degree student? (If so, please list below)

III. EMPLOYMENT

Current Position Title:

Name of Employer:

Employment Dates (mm/yy to mm/yy):

Brief Job Description (50 words or less):

IV. Statement of Interest

Please address the following two questions. Please use the additional comment section for any other information you would like to include. If additional space is needed, please type on a separate sheet.

  1. How will this certificate training contribute to your career plans?
  1. Please describe work or volunteer experiences, including domestic or international experiencesthat shaped your interest in pursuing the certificate program for which you are applying?
  1. Additional Comments:

I have read the attached instructions, and hereby certify that to the best of my knowledge the information furnished on this application is true and complete. I understand that if found to be otherwise, it is sufficient cause for rejection or dismissal.

Date (mm/dd/yyyy):

Signature – please TYPE in your name below as your signature if you are submitting electronically.

If submitting the application via US mail, please include your signature on the line below:

______

CSPH 4/26/11