Health Services Research Application for Admission | Rehabilitation and Health Services

Application for Ph.D. Program in Health Services Research

Concentration *

Applied Gerontology

Audiology & Speech-Language Pathology

Behavior Analysis

Rehabilitation Science

Contact Information

Name *

Last 4 digits of SSN (use XXXX if international)

Phone Number *

Email Address *

Current Address *

Zipcode *

State *

Education

Enter latest information only. Additional education should be listed in your resume.

Name of Institution *

Date From *

Month

Day

Year

Date To *

Month

Day

Year

Address of Institution

Degree Received *

GPA *

GRE Scores

Verbal

Quantitative

Analytical Writing

GRE *

I understand that official GRE scores must be sent to the University in order to have my application processed.

Required Documentation

Statement of Intent *

Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.

Resume *

Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.

Sample of Written Work

Files must be less than 4 MB.
Allowed file types: rtf pdf doc docx.

Three Letters of Recommendation are also required.

The person completing the letter of recommendation, should send the letters to:

Callie Stanford
Department of Disability and Addiction Rehabilitation
University of North Texas
1155 Union Circle #311456
Denton, TX 76203-5017

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