Undergrad Certificate in CTS Application

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Thank you for your interest in this program!

In order to start your application to the Undergraduate Certificate program in Clinical and Translational Science, please complete the survey below. Contact Anna Johns at johns7a8@uc.edu if you have questions or run into any issues.

Please note that after you submit the below form, we will also pull your UC academic record and add it to your application file for review by the admissions committee.

Your Last Name:

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Your First Name:

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UC Email Address:

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Your UC M#:

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Please enter your major (e.g., Medical Sciences or Psychology):
If undecided, please enter Undecided.

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Please enter any minors you are pursuing:

Please select your primary college affiliation within UC (i.e., the college in which your major is offered):

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College of Medicine

College of Nursing

College of Pharmacy

College of Allied Health Sciences

College of Arts & Sciences

UC Blue Ash

College of Business

UC Clermont

College-Conservatory of Music

College of Cooperative Education & Professional Studies

College of Design, Architecture, Art & Planning

College of Education, Criminal Justice & Human Services

College of Engineering & Applied Sciences

UC Online

Not Applicable/Undeclared

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Please select the semester you anticipate starting the Certificate program:

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Fall Spring

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How did you hear about this program?

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Class presentation

Advisor

Another student

Student organization

Email Listserv (please list)

Other (please list)

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Please tell us how you heard about us:

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Upload your personal statement here. A personal statement should be one page or less and describe your educational background up to this point, why you are interested in the Certificate in Clinical and Translational Science, and how the Certificate might help you achieve your career goals now or after graduation.

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A letter of recommendation is preferred, but not required. This letter should ideally be from a professional or academic reference (e.g., work manager or faculty member). Do you intend to upload a letter of recommendation?

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Yes

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Submitting a letter of recommendation is preferred, but not required. If you have a letter of recommendation already, please upload it here. Recommenders can also email letters of recommendation directly to Anna Johns: johns7a8@uc.edu.

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If you choose to have your recommender email your letter of recommendation after submitting this application, please provide the recommender's first and last name here:

Please provide your recommender's email address here:

What is your gender?

Woman

Man

Non-binary, transgender, or gender non-conforming

Prefer not to report

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What is your race and/or ethnicity? (check all that apply)

American Indian or Alaska Native (e.g., Navajo Nation, Blackfeet Tribe)

Native Hawaiian or other Pacific Islander (e.g., Samoan, Fijian)

Asian (e.g., Chinese, Vietnamese)

Black or African American (e.g., Nigerian, Somali)

Hispanic or Latino (e.g., Mexican, Puerto Rican, Guatemalan)

White (e.g., English, German, Italian)

Middle Eastern or North African (e.g., Lebanese, Iranian, Syrian)

Unknown or Not Reported

Do Not Wish to Provide

Do you have a disability? The Americans with Disabilities Act (ADA) defines an individual with a disability as a person with a physical or mental impairment that substantially limits one or more major life activities.

Yes

Do Not Wish to Provide

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Are you from a disadvantaged background?

Individuals from disadvantaged backgrounds are defined as those who meet two or more of the following criteria:
1. Were or currently are homeless;
2. Were or currently are in the foster care system;
3. Were eligible for the Federal Free and Reduced Lunch Program for two or more years;
4. Have/had no parents or legal guardians who completed a bachelor's degree;
5. Were or currently are eligible for Federal Pell grants;
6. Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child;
7. Grew up in one of the following areas: a) a U.S. rural area, or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas. Only one of the two possibilities in #7 can be used as a criterion for the disadvantaged background definition.

Yes

Prefer not to report

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BECOME A CCTST MEMBER TODAY!

Register here at cctst.uc.edu/user/register to unlock these and many other perks!

CCTST Membership includes:

Consultations and access to programs.
Resources for researchers, community members, and research coordinators.
Research tools ranging from planning and design to data analysis.
Access to events and education opportunities.
Extensive funding opportunities.

CCTST members can benefit from most of the services above at no cost.

Admissions Decision

Admit

Deny

Conditional Acceptance

Incomplete

Withdrew

Dropped

Pending change of program request

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Please add any notes here regarding the admission decision:

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.