Please print clearly or type. Due to the individualized, self-directed nature of our programs, please complete this application carefully and thoroughly as this application identifies who you are academically, professionally, and personally. This application form will be regarded as confidential and used only in the admission process and by appropriate University officials. In connection with the application, the applicant understands that a consumer report, which may contain public records information, may or will be requested. Use a separate sheet of paper when necessary.

Personal Data

Name: Mr./Ms./Mrs./Dr./(Last)_________________________(First)___________(MI)____
Present Address: _________________________________________________________
(City)_________________________(ST)_____(ZIP)_________(Country)_____________
S.S.#:___________________________________________________________________
Phone(H):__________________________(Best time to call)________________________
Phone(W):__________________________(Best time to call)________________________
Date of Birth:(Month)_______(Day)_______(Year)_______
Computer:yes/no (Type)_____________________________________________________
E-Mail Address:____________________________________________________________
Present Occupation/Title:___________________________________________________
Employer/School:__________________________________________________________
Citizenship:_________________________Native Language:______________________

Employment

List most recent first. If available, please enclose a copy of your most recent resume.
      Employer/Address                                                    Dates from/to             Position/Title
1.
2.
3.

List most recent first. Please use a separate piece of paper if necessary.
      Employer/Address                                                    Dates from/to             Position/Title
1.
2.
3.

Briefly describe the most important job skills and interpersonal skills you have developed through work or activities.

Please list two references from whom we should expect letters of recommendation. Ask two people who are not related to you. One should include an employer or a teacher/professor who can provide insight into your capabilities.
       Position/Title
1.
2.

Incoming Credit

The University accepts incoming credit toward a student's first degree program. Not only is relevant academic credit considered, but the University recognizes that individuals learn on their own or through their work as well. Thus, incoming credit may be considered for life and work experience. If you are applying for incoming credit for life and work experience, please submit your portfolio for incoming credit with your application
I am applying for Incoming Credit from my academic transcripts.    yes    no
I am applying for Incoming Credit from my work experience.    yes    no

Education

1. Undergraduate/Graduate Institutions:
   Begin with last attended. Please use a separate sheet of paper if necessary. Official transcripts must be received as soon as possible, however copies of your transcripts are acceptable initially for the evaluation process. All transcripts must be received for a complete evaluation.
         Name Address                                Dates Degree/     Credits Earned
   1.
   2.
   3.
   4.
2. List Publications, Honors, Awards:
   
3. Comments:
   Briefly describe the challenges and accomplishments of your educational experience.
   

Check List

1. If not included please indicate which items are being sent separately:
   ____ Completed Application Form
   ____ Official Transcripts (copies are unacceptable)
   ____ Two-Three Page Essay
   ____ Application Fee: Basic=$50.00
   ____ Three (3) Passport Size Photos (Taken Within Five Years)
   ____ Two (2) Official References
   ____ Payment Options (Financial Information) Sheet
   ____ Incoming Credit Portfolio (If Applicable)
2. I am sending official transcripts from:
   1.
   2.
   3.
   4.
   5.
   6.

Your essay, along with you completed application, is an opportunity for the University to assist you in the process of designing your program and educational goals to best fit your individual needs. Because the programs offered require the student to work more independently, communication and writing skills are emphasized. Your essay will be an important tool for the admissions committee to identify areas of strength as well as areas where added focus and attention would improve your academic and professional career. Please address, but don't limit yourself to, the following areas in your essay. It should be no more than 2-3 double spaced, typed or word processed pages.

1. Reflect upon your personal and professional history. How has this influenced your growth and contributed to your decision to seek admission to the University of Natural Medicine and to the program(s) of your choice?
   
2. Your most valuable asset is your life experience. Our programs are designed to help you to build upon your own experiences and special talents. Above all, we value your special individuality and ability to reflect upon your own life and learning. What have been your most valuable learning experiences and how do you incorporate these experiences into your life?
   
3. How do you view yourself and what do you value most about your self? What are the challenges you might face in order to successfully complete your course of study? What are your goals, dreams and visions for the future and what do you plan to do with the degree or diploma you seek from the University?
   

I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS COMPLETE AND ACCURATE. I UNDERSTAND THAT ANY MISREPRESENTATION MAY BE CAUSE FOR REJECTION OF SUBSEQUENT DISMISSAL FROM THE UNIVERSITY OF NATURAL MEDICINE. APPLICATION MATERIALS BECOME THE PERMANENT PROPERTY OF THE UNIVERSITY OF NATURAL MEDICINE. I ACKNOWLEDGE THAT THE APPLICATION FEE IS NON-REFUNDABLE.

Signature of Applicant______________________________ Date__________________

Thank you for submitting your application to The University of Natural Medicine.

The University does not discriminate on the basis of gender, religion, race, age, color, natural origin, sexual orientation, political affiliation or physical impairment for admission to any program or activity.