Once submitted you will be contacted through the e-mail you listed in Section 1 - Personal Data.
Please contact Hailey McCormick at hailey.mccormick@utah.edu or 801-585-6808 with questions.

What type of Certificate?


Certificate in Global Health
Certificate in Public Health

Are you considered a resident by the University of Utah?


Yes
No

Term and Year applying

(Choose only one)

SECTION 1 - PERSONAL DATA

SECTION 2 - ACADEMIC BACKGROUND

SECTION 3 - GLOBAL HEALTH CERTIFICATE APPLICANTS ONLY

List the semesters and year you plan on taking each core course:

List the semesters and years you plan on taking each approved elective:

SECTION 3 - PUBLIC HEALTH CERTIFICATE APPLICANTS ONLY

List the semesters and year you plan on taking each core course:

SECTION 4 - LETTER OF INTENT

Describe why you are interested in this Certificate program: