Skip Navigation




*Complete the following form to apply to the Urban Public Health Graduate Program. For the final step of the application, a non-refundable application fee of $75 must be submitted online via PayPal.

= Required

Personal Information
Address Information
    Please enter your Primary address first.

Contact Information
  1. Phone Type Country Phone Number Primary
Demographic Information
Ethnicity and Race Information
  1. Are you of Hispanic/Latino ethnicity or descent? Yes No
    Select one or more races with which you identify yourself:
    American Indian or Alaska Native
    Black or African American
    Native Hawaiian or Other Pacific Islander
Citizenship Information
Government Information
  1. Calendar
  2. Calendar
Academic Information
  1. .
Test Scores
  1. Test Type Score Date Taken
Emergency Contacts

  1. Employer Name Position Start Date End Date
Education History

  1. Degrees



Online Application Policy
  1. To submit this application, you must visit the PayPal website to submit the application fee. After payment, select "I accept" to confirm that you have read and fully understand the terms and conditions set forth in our Application Policy . When you click on the submit button, you will be directed to PAY PAL for payment. When you make your payment, your application will be submitted.

    I do not accept I accept