Office of the Registrar ● 1310 Club Drive ● Vallejo, CA 94592 ● phone: 707‐638‐5984 ● fax: 707‐638‐5267 ● email:
[email protected] ● website: http://tu.edu
REGISTRATION FORM Academic Program:
□ DO □ MSMHS □ Pharmacy □ Education □ Joint MSPAS/MPH ☒ Public Health
Name
Class of
Student ID#
_
SEMESTER (PLEASE SELECT ONE): □ SUMMER ☒FALL □ SPRING YEAR: _2012___ Full-Time Enrollment – Global Health Track COURSE NUMBER
COURSE NAME
UNITS
Core Courses PH 607 1A
Biostatistics
3
PH 608
Behavioral and Social Aspects of Public Health
3
PH 648
Environmental Health
3
_
3
_
Track Course PH 620
Essentials of Global Health
Total Units This Semester
12
I agree to abide by the rules and regulations of Touro University California, and to uphold Touro University California standards of social and academic conduct at all times while on campus and while participating in clinical rotations. Student Signature
Date
For Office Use Only:
Date Received by Registrar’s Office Bursar Approval
Date Registration Completed
Processed by
Program Approval Name of Authorized Program Representative (please print) Signature Office of the Registrar – Registration Form
Date 2/8/12 VJ