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[MSHCI] HCI Application Evaluation
"
*
" indicates required fields
Is this a readmission?
Yes, this is a readmission request
Check this box only if the student was previously admitted and is now applying for Readmission
Enrollment Advisor
*
Please select an advisor
Jerome Guidetta
Jake Schneidmiller
Robinelle Nunez
Allison Rogers
Nicole Sampson
Corinne Williams
Application Term
*
Indicate start term
Fall 2023
Program Format
*
Online
Campus
Full time or part time?
*
Full time
Part time
International students must choose full time
Desired Specialization
*
Choose Specialization
Informatics
Analytics
Leadership
Applicant Preferred First Name
*
Applicant Formal First Name
Fill this out only if different from above
Applicant Last Name
*
Student ID#
*
Applicant Email
*
Must match the primary email address currently in Radius!
Applicant phone number
*
In case there is problems with the admission interview login
Residency
*
Domestic
International
Applicant's nursing license, if any
*
RN
BSN
Applicant is not a nurse
Educational Qualifications
Education Requirement
*
BA/BS from a Regionally Accredited Institution
BA/BS from a Nationally Accredited Institution
Degree from international university (with WES eval)
Degree Granting Institution
*
Degree Earned
Applicant's GPA
*
Please enter a number from
2.0
to
5.0
.
Professional Qualifications
Months of Related Work Experience
*
Current Profession
*
Select current professional role
Clinical data manager
Clinical Informaticist
Clinical Laboratory Tech
Clinical Nurse
Computer and Information Systems Manager/Director
Computer Science Manager/Director
Computer Systems Analyst
Educator
Health Information Management/EHR
Information Technology in Health Care organization
Information Technology - non Health care
M.D. - credentialled in U.S.
M.D. - foreign trained/non-credentialed
Nurse in non-clinical setting
Nurse Informatacist
Nurse Practitioner
Nurse Manager
Other
Pharmacist/PharmD
Pharmacy technician
Researcher
Student
Unemployed
Other
Current Job Title
*
Employer Name
*
Summary of Health Care Experience
*
Technical Aptitude and Experience
*
Understanding of medical terminology
*
Has knowledge of medical terminology from past health care experience
Needs to take Medical Terminology course
Optional comments regarding experience
Final Application Checklist
Admission Interview status
*
Admission interview is scheduled
Date/time of admission interview
*
Letter of Recommendation Summary
*
Letter from employer is “Recommend” / “Strongly recommend” candidate.
Letter from employer expresses “Some reservations” in recommending candidate.
Letter from employer states “Do Not Recommend” for the candidate regarding graduate study.
Recommendation letter does not come from current employer, but candidate has submitted 2 letters of recommendations
Status of English Proficiency Test (EPEX)
*
Received
Waiver requested
Waiver approved
Other
Optional final comments regarding applicant
Additional Applicant Information
All the information provided in the fields below will be used to update the applicant's record in Radius, but will not factor into the admission decision.
Country
*
Select Country
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Street Address
*
City
*
Province
Select Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State
*
Select State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
Virgin Islands
WA
WV
WI
WY
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
International/Outside US
State/Province
*
Zip/Postal Code
Gender
*
Male
Female
Ethnicity
*
Select ethnicity
White,non-Hispanic
Black,non-Hispanic
Hispanic
Asian/Pacific Islander
American Indian/Alaska Native
Race/ethnicity unknown
Other
Date of Birth
*
Month
1
2
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5
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12
Day
1
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Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
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1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
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1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
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1975
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1967
1966
1965
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1963
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1958
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1956
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1954
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1952
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1950
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1948
1947
1946
1945
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1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Required even if already in Radius due to technical glitch - sorry!
Hidden
Incentive Deadline Met
Yes
No
Payment Type
Employer Tuition Assistance
Financial Aid
GI Bill / VA
Out of Pocket
Payment Plan
Scholarship / Grant
Yellow Ribbon
Select up to 3
Application Influence
Campus Visit
Graduate Fair
College Guidebook/Magazine
Employer
Friend(s)
Information Session
Online Advertising
Open House
Other
Print Advertising
Professional Directory
Ranking
Relative
TV/Radio Advertising
USD Alumni
USD Brochures
USD Faculty/Admin/Staff
USD Student
USD Website
Web Search
Select Up to 3
List all other schools to which the applicant is applying
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