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Accelerated MPH Program Petition Form

Name of Student:  

Student ID:  

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Your UofL E-Mail Address  

Degree Program Currently Enrolled in:  

Credit Hours Earned:  

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Degree Desired:  MPH- concentration EpidemiologyMPH- concentration Health Promotion and BehaviorMPH- concentration Global Public HealthMPH- concentration Health PolicyMPH- concentration Undecided

UofL Grade Point Average:  

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Cumulative Grade Point Average:  

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Anticipated Undergraduate Graduation Date:

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Anticipated Graduate Graduation Date:

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Brief statement: Why you're interested in the accelerated bachelor’s/master’s program. Include your main academic interests, strengths, & limitations.  

Specify what you personally hope to accomplish during your program here.  

Explain any special circumstances you feel should be considered in the application process:

If selected for admission, how can we as a program support you through completion?

I have read and understand the policies for participation in the Accelerated Degree Program.  

Type name for electronic signature:  

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