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USU Global Health Distance Learning Program
Add your information to this form if you would like to be kept up-to-date and emailed information about the program. Admissions are currently on hold.
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Last name
*
Your answer
First name
*
Your answer
Middle name
Your answer
Best email
*
Your answer
Optional: Second email address. For your convenience, we will send all correspondence to both addresses.
Your answer
What is your affiliation?
*
Active U.S. Air Force
Active U.S. Navy
Active U.S. Army
Active U.S. Marine Corps
Active U.S. Commissioned Corps Public Health Service
U.S. Air Force Reserve or Guard
U.S. Navy or Marine Reserve or Guard
U.S. Army Reserve or Guard
U.S. PHS Reserve or Guard
Civilian employee of the DOD
Civilian employee of the U.S. government (non-DOD) (e.g. State, USAID, CDC, etc.)
International military partner
Civilian, U.S. citizen, no federal government affiliation
Other:
Optional: If there is anything else of which you would like the program administrators to be aware, feel free to enter it here.
Your answer
Thank you for your interest in the program! We're sorry that we're unable to accommodate all students sooner.
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