Health Profession Application
Profile
First Name
Last Name
Address
Address 2 (Apt, Suite etc)
City
State
- Select State -
AL
AK
AS
AZ
AR
AE
AA
AE
AE
AE
AP
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Zip
Home Phone
E-mail
Profession Applying to
- Select -
Allopathic
Osteopathic
Dentistry
Optometry
Pharmacy
Veterinary Medicine
Physician Assistant
Podiatry
Other
Additional Profession Applying to
Current Student Status
- Select -
Undergraduate
Post Bacc
Recent Alumni (less than 1 year)
Alumni (more than 1 year since graduated from CSUF)
Are you applying this application cycle?
Yes
No
Notes:
Undergrads, current Post Bacc, recent alumni (less than ONE year)
- $20.00 fee per professional program
Alumni more than ONE year
- $100 flat fee
** Disclaimer: Fees are non-refundable and cannot be rolled over to future intent to apply application cycles **