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Information Request Form

Please enter the following information and then click on "Submit" at the bottom of the form to send the information. The request will be processed and information will be sent to you as soon as possible. Thank you for your interest in the College of Health Sciences.

Name:
Address:
City:    State:    Zip:
E-mail:

Check the boxes of items you are interested in receiving information about (You can choose more than one):

Application for Admission
General Information
   
Baccalaureate Degree (4 Year) Certificate Program
Nursing (R.N.) Health Information Management
R.N. Pursuing BSN Coding Certificate
Health Services Administration  Medical Administrative
Occupational Science
Environmental Health Science
Recreation and Park Administration  
Clinical Laboratory Science - Upper Division  
  Pre-Professional
Associate of Applied Science Degrees (2 Year) Pre-Physical Therapy
Nursing (R.N.) Pre-Dental Hygiene
Medical Assisting Technology Pre-Physician Assistant
Clinical Laboratory Technology
Early Childhood Development

Please enter any additional information you would like or any comments:


      
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Eastern Kentucky Univeristy
College of Health Sciences
Rowlett 203
521 Lancaster Avenue
Richmond, KY 40475-3102