ࡱ> c bjbj 4WbWbs T T 8l<-fE,G,G,G,G,G,G,$h.1k,Qk,,RE,E,)hS*%<)1,,0-)11 S*S*&1y*0" k,k,6-1T B : Important reminders: a. GRE scores are sent directly to the Department. You must request for an official copy to be sent to California State University Dominguez Hills, Department of Occupational Therapy (GRE: School Code 4098; Dept Code 0618). Note: You should upload an unofficial copy of your GRE scores in case your official copy gets deferred. You should also add proof that you have requested for a copy to be sent to the Department, if CSUDH is not one of the institutions indicated in the copy of your score included in the packet. b. Be sure to remind those persons you have asked for letters of recommendations to complete before the September 15 deadline. c. Make sure you fill in all items on the MSOT Application Checklist and MSOT Application Form as accurately as possible. These forms will be used by the Admissions Committee and unclear and inaccuracies may delay the processing of your application. MSOT APPLICATION CHECKLIST Name: Date:Semester/year of Application:  ItemRequirements"Official Score sent to OT Dept (yes/no)Date CompletedCombined Score (minimum 140 Quant & 146 Verbal)Analytic Writing Score (minimum of 4)1GRE (within 5 years) with copy of unofficial record in packet (")2Degree Requirement: MajorDate CompletedGPA InstitutionBS/BA Degree with official transcript 3Prerequisite Courses (3 semester units each) taken within last 10 years with official transcripts  Course # Date Completed Grade Institutiona.Developmental Psychology (Across the Life Span)b.Abnormal Personality or Abnormal Psychology c.Human Anatomy with Labd.Human Physiology with Labe.Statisticsf.Medical Terminology4Verification of Observation (proof of at least 80 hours or completion of Intro to OT Workshop)Date CompletedName of ReferenceFacility or Institution of Reference Number of Hours Completed MSOT Program Application Form Must Be Typed 1. Name: , Student ID# (Last) (First) Note: Student ID number is sent to applicant few days after completion of CAL STATE Apply University application by the CSUDH Admissions and Records Office. If not available upon application, leave it blank. 2. Address: (Street) (City) (State) (Zip Code) 3. Phone: H ( ) C ( ) Email Address 4. Citizenship: California Veteran: yes % no % 5. Post Secondary Education: Please document beginning with most recent College/University attended. Name of College/UniversityDate(s) AttendedUnits/Degree EarnedGPAa.b.c.d.e. 6. Relevant Work Experience: PositionCompany/InstitutionDate of Employmenta.b.c. 7. Verification of References: (List contact information of individuals who provided letters of recommendation) Name Position/Title Facility/Institution Telephone/Contact Info a. b. c. Extra Curricular Activities (e.g clubs/organizations, accomplishments, other volunteer, special interest) Applicant must certify by signature below: I have read the Graduate Studies section of the University Catalog and understand and agree to the policies and procedures including the requirements, that if I am accepted, I will have to proceed in a cohort, taking all course work in the sequence offered. 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Finally, no fees or expenses are refundable. By signing below, I understand and agree to all of the stipulations, policies and procedures associated with this program. 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