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Section I. Personal Information



First Middle Last

Mailing Address:



Section II. University of Chicago Affiliation

Please note: Students accepted to the Graduate Program in Health Administration and Policy must first be admitted to one of the participating professional schools: Booth School of Business, Harris School of Public Policy Studies, Law School, Pritzker School of Medicine, or School of Social Service Administration.

Are you currently enrolled in one of these schools?

____ Yes Student I.D. # ________________

____ No

Expected graduation year:______________ quarter:_________

Please indicate the school(s) in which you are enrolled or to which you are applying:

_____ School of Social Service Administration:

□ Clinical practice concentration □ Social Administration concentration

_____ Harris School of Public Policy Studies

_____ Law School

_____ Booth School of Business:

□ Full Time □ Part-time □ Evening/Weekend

_____ Pritzker School of Medicine

_____ Booth School of Business/Pritzker School of Medicine

_____ Other Joint Degree Program (please specify): ___________________

The Graduate Program in Health Administration and Policy has two tracks – one that focuses primarily on the U.S. Health Care System, and one that focuses primarily on global health. Global health in this context refers to health care in low and middle-income countries. You may select which track is of most interest to you. The two tracks have different required courses, but the electives may overlap. Students on both tracks will be considered part of the same GPHAP class/cohort.

Please indicate the GPHAP track for which you are applying:

_____ U.S. Health Care System - Certificate in Health Administration and Policy

_____ Global Health - Certificate in Health Administration and Policy with a Concentration in Global Health

Section III. Academic Background

Please list or attach resume:

University Degree Major Dates of Enrollment


Professional Background and Experience (Please list or attach resume):

Please detail your professional experience, particularly any health care experience. Also include information about promotions or other professional honors.

Organization Title Type of Work Dates of Employment/Service

Personal Statement:

On separate sheets of paper, please write an essay explaining why you would like to be admitted to the Graduate Program in Health Administration and Policy. Discuss your personal experiences, beliefs, and interests, as well as your previous training and education, and indicate why you wish to pursue a career in health care. Describe how the Program’s curriculum will help you achieve your goals. Also indicate which health care settings and/or professional positions interest you the most. If you are applying for the Global Health track, please discuss your interest in global health. This essay is crucial to the admission process, and should be 2-3 pages long.

Contact Information:

Please mail or E-mail this form, along with supporting materials, to Laura Botwinick, Director, Graduate Program in Health Administration and Policy, at Microsoft Word or Adobe PDF documents are acceptable. Applications are due by September 4, 2014.

Mailing address: Physical Location:

969 E. 60th Street 6011 S. Ingleside

Chicago, IL 60637 Chicago, IL 60637

Phone: 773-702-1324



Section IV. Brown Fellowship Application (optional)

The Ray E. Brown Fellowship aims to identify and support exceptional students who are committed to the health care field and wish to pursue the Graduate Program in Health Administration and Policy while at the University of Chicago. In addition to attracting talented students to the program, the Brown Fellowship provides the opportunity for students to develop leadership skills and fosters interdisciplinary experiences through projects and activities associated with the fellowship.

One incoming student from each of the following schools - Booth School of Business, Harris School of Public Policy, the Law School, and School of Social Service Administration - will be selected to receive a $5,000 fellowship to be distributed over two years. In addition, one Pritzker School of Medicine student on the Global Health track also will be selected. The Pritzker Student will be paid over three years with payments made in the second, third and fourth years of medical school.

Brown Fellows are expected to complete the requirements of GPHAP as well as participate in the following leadership activities:

▪ Act as a GPHAP student representative from their respective schools by communicating needs and interests of students to GPHAP faculty and staff, and by speaking with prospective students as needed.

▪ Attend GPHAP events and encourage others to do so to promote networking and cohesion among GPHAP students.

▪ Work with other Brown Fellows to plan and coordinate three GPHAP events that advance the understanding of health care issues on campus and promote the interdisciplinary aspects of the program.


To apply for the Brown Fellowship, students must submit a completed GPHAP application. In addition to the GPHAP application, Brown Fellow candidates must provide the following information:

▪ Copy of student’s undergraduate transcripts.

▪ One page letter of recommendation from a former supervisor or colleague in a health related position.

▪ Personal statement regarding student’s leadership qualities and experience.

Please note: If you are not applying for the Brown Fellowship, we do not need your transcripts or a letter of recommendation. The transcripts, letter of recommendation, and second personal statement on leadership are required only for those who are applying for the Brown Fellowship.

Applicants for Brown Fellowships must be full-time students in their respective schools (Booth, Harris, Law, SSA, Pritzker).

Applications will be reviewed by the GPHAP Faculty Committee and GPHAP Director, and evaluated according to the following criteria:

▪ Commitment and passion to the healthcare field.

▪ Good academic standing.

▪ Understanding of the value of interdisciplinary and collaborative approaches.

▪ Ability and willingness to take a student leadership role in the program.


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