Applicant Track for Students Applying to Professional Schools in 2022

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DESCRIPTION: This form is for students applying to professional health programs in Spring/Summer/Fall 2022.

We are excited that you are taking the next step in planning to apply for a professional health program in 2022! This form will allow the Office of Pre-Professional Health Programs to know and track your progress. There will be important and timely emails throughout the year to help prepare you for the process. In addition, there will be options to attend the Applicant Track Training series throughout the fall OR spring semester!

The Applicant Track Trainings best prepares you for the application process so that you know what you need to know! This year, it will be run one time in the fall semester and one time in the spring semester. It is also available online for students to watch at anytime (PHP website and click on Workshops) Once scheduled, you will receive information about the workshops and be able to RSVP.

In order to gain more information about you for aggregate data collection, there are additional optional questions below to answer as well.

If you have any questions at all, please do not hesitate to contact Megan Carbone, Coordinator, Pre-Professional Health Programs at m.carbone@csuohio.edu.

It is our privilege to help you throughout your application process!

First Name: *

Last Name: *

CSU ID Number: *

Cell Phone Number: *

Email: (Personal Email Preferred!) *

Please select your Pre-Professional Category: *

Pre-Anesthesia Assisting

Pre-Dental

Pre-Law

Pre-Medicine

Pre-Optometry

Pre-OT

Pre-PA

Pre-PT

Pre-Pharmacy

Pre-Speech Pathology or Audiology

Pre-Veterinary

Other:

What was your relationship with CSU when you attended/while attending? *

Post Baccalaureate Student

Undergraduate Student

The following questions are optional and for data collection purposes only. Do you identify as:

Male

Female

Neither

Clear selection

Please select your race:

African American

Asian or Pacific Islander

Caucasion

Latina/o or Hispanic

Indian

Middle Eastern

Native American

Other:

Do you identify as a part of the LGBTQ Community?

Yes

Clear selection

Are you a first generation college student?

Yes

Clear selection

Are you a first generation American?

Yes

Clear selection

Are you active military or a military veteran?

Yes

Clear selection

Did you grow up in a low income household?

Yes

Clear selection

Do you consider yourself underrepresented and going into healthcare? If so and if it has not been asked above, feel free to write in a response below.

Submit

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