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Admissions Application

* denotes required field

Name

Legal Name*
Preferred Name

Address

Permanent Address

Street*
City, State, ZIP*
Country*

Current Address (if different)

Street
City, State, ZIP
Country

Personal Information

Gender*
Social Security*
Birth Date (mm/dd/yyyy)*
Place of Birth

Contact Information

Home Telephone* Mobile Telephone
Email Address*

Emergency Contact

Name* Telephone*

Plan of Study

Program*
Please Specify the Year and Term in which You Wish to Enroll*
Have you attended college before?
Transfer Student* I intend to transfer credits from another degree program

Application fees are waived for students applying for courses offered by the Institute of Science (IoS) or the Bachelors Completion Program (BCP). Please contact an Admissions Advisor for your application fee waiver code.

^ No classes on Easter weekend (4/18-4/19) ^^ No classes on 4th of July weekend ^^^ No classes on Thanksgiving weekend (11/28-11/29) ^^^^ No classes on Easter weekend (4/03-4/05) ^^^^^ No classes on 4th of July weekend ^^^^^^ No classes on Thanksgiving weekend (11/26-11/29)

Academic Information

High School Last Attended*
City, State*
Graduation Date (Month/Year)
If you are not a high school graduate, when did you complete your GED (Month/Year GED was taken):
List in chronological order all post-secondary institutions you have attended regardless of length of attendance and even if no work was completed. Include previous attendance at this institution and any correspondence or extension courses taken. Attach an additional sheet of paper, if needed. (Official high school or GED and all college or university transcripts must be sent to the Office of Admissions. Failure to list all colleges or universities in which you have been enrolled, regardless of status,may disqualify your application.) For Institute of Science (IoS), list your colleges or universities only if registering for courses with pre-requisites.
Institution Name City/State Dates Attended Degree Earned

Extra-Curricular Activities

Briefly describe your involvement in any extra-curricular activities in which you participated. Please include any scholarships or scholastic honors/awards, etc. received. Maximum 250 Words.

Personal Statement

State why you are interested in becoming a Doctor of Chiropractic, Licensed Acupuncturist, Massage Therapist, or taking accelerated science courses through the Institute of Science. For the Bachelor Completion Program, please write a three page essay on your interest in attending SCU’s BCP and include your understanding of integrative medicine, integrative health and the future opportunities and need for interprofessional practice. Minimum 300 Words.*

Demographic Information

Ethnic Background*
Marital Status*
Are you a United States Citizen?*
Is English your first language?*
Are you a US Veteran of the Armed Forces?*

If yes, would you be interested in participating in our government assistance program?

Non-U.S. Citizens

What is your current immigration status?
Other (Please Specify)
Country of Citizenship

Other Information

Have you ever been convicted of a Misdemeanor or Felony?*



If yes, please explain
Have you ever been dismissed or suspended from any college?*

If yes, please explain when and why?
Are you a relative of a SCU Student or Graduate?*

If yes, whom (Name and Relation to You)?
Will you be requesting financial assistance from SCU?

Please let us know what SCU finance options you would be interested in learning more about. Please check the following boxes you are interested in.

How were you first introduced to SCU?

Please state referring individual(s) name, address and phone number
Are you transferring from a like University?


Are you applying to other schools/universities?


If yes, please list below:
Who was your advisor? *




 

1 Stay connected with SCU -By providing us with your mobile number, we can send you text messages with useful information about the admissions process, deadlines, and reminders about special events in your area. By checking the box above, you hereby consent to receiving text messages from SCU, either manually or via an automated system. We don't charge for this service, but depending on your text messaging plan, your phone company may charge standard text message rates. Your participation is not required as part of our admissions process or to be a student at SCU. We hope you enjoy receiving e-mail notices and updates from Southern California University of Health Sciences (SCUHS). If you do not wish to receive text messages to opt out of these messages at any time, go to http://www.scuhs.edu/sms-opt-out/, or contact our admissions department at (877) 434-7757.
2 Degree title subject to change