Master of Science Application
for the 2008 entering class
PROGRAM  
   Master of Science in Biomedical Sciences (M.B.S.)    
   Master of Science in Anatomy (M.S.A.)    
   
PERSONAL INFORMATION
Social Security Number:         Gender: Female  Male         Date of Birth: (month/day/year)
Full Name  Last:   First:   Middle:
Former Name (if any)    Last:     First:     Middle:
Preferred Name:
   
ADDRESS INFORMATION
Current Mailing Address  Street:   Apt:   City:   State:   Zip:  
Permanent Address?    Yes   No    Valid Until: 
Permanent Address  Street:   Apt:   City:   State:   Zip:  
Day Phone Number:    Evening Phone Number:    Cell Phone Number:
Email Address:
 
CITIZENSHIP
What is your state of residence?   
U.S. Citizen   Permanent Resident   Non-U.S. Citizen
          If Non-U.S. Citizen, Citizen of :     Current Visa type (if applicable):
          Native Language:     Language Spoken a Home:
 
ETHNICITY (Optional - U.S. Citizens and Permanent Residents only)
Hispanic/Latino/Chicano/Puerto Rican Asian or Pacific Islander Black, not of Hispanic origin
White, not of Hispanic origin American Indian or Alaska Native  Other (please specify)
 
TEST DATA (Please provide all scores for all tests taken.)

Graduate Record Examination (GRE)
Date of planned exam:
Date taken:
Verbal
Quant.
Analytical/Written
Date taken:
Verbal
Quant.
Analytical/Written
Date taken:
Verbal
Quant.
Analytical/Written

Medical College Admission Test (MCAT)
Date of planned exam:
Date taken:
Physical Sciences
Verbal Reasoning
Writing Sample
Biological Sciences
Date taken:
Physical Sciences
Verbal Reasoning
Writing Sample
Biological Sciences
Date taken:
Physical Sciences
Verbal Reasoning
Writing Sample
Biological Sciences

Dental Admission Test (DAT)
Date of planned exam:
Date taken:
Quantitative Reasoning
Reading Comprehension
Biology
General Chemistry
Organic Chemistry
Perceptual Ability
Date taken:
Quantitative Reasoning
Reading Comprehension
Biology
General Chemistry
Organic Chemistry
Perceptual Ability
Date taken:
Quantitative Reasoning
Reading Comprehension
Biology
General Chemistry
Organic Chemistry
Perceptual Ability

Test of English as a Foreign Language (TOEFL)
Test Type:  Internet   Paper   Computer Date taken:    Total Score:
Test Type:  Internet   Paper   Computer Date taken:    Total Score:
 
POST-SECONDARY EDUCATION
Please list in chronological order all the colleges and universities you have attended.  Official transcripts should be sent to Des Moines University, MS Admission, 3200 Grand Avenue, Des Moines, IA 50312.
 
Educational Institution Major GPA Degree Awarded Dates of Attendance

Have you ever been dismissed or suspended from any school, college, university, or place of employment?   Yes  No
If yes, please explain:

Have you ever been convicted of a felony?   Yes  No
If yes, please explain:

Have you ever been convicted of a misdemeanor (excluding parking violations)?   Yes  No
If yes, please explain in detail:

If you have a pending misdemeanor  or felony which results in a conviction, it is your responsibility to immediately update your application.
 
LETTERS OF RECOMMENDATION
Please provide the names of three individuals who have agreed to write  a letter of recommendation for you.  A DMU form must be submitted with your letter and can be found here.  Letters and forms should be sent to Des Moines University, MS Admission, 3200 Grand Avenue, Des Moines, IA 50312.
Name Position Relationship
 
RESEARCH EXPERIENCE
Please list any research experience.  If you need more room, please discuss your research in your Personal Statement or in the Comments section.
Institution Lab Chief (P.I.) Dates Project Title or Description
 
EMPLOYMENT
In chronological order, please list your work experience.
Employer Position Type of Work Dates of Employment
 
PERSONAL STATEMENT
Please include a one to three page personal statement describing why you are interested in the particular field of study and why you would like to attend Des Moines University.
 
OTHER INFORMATION (optional)
Please list any Des Moines University faculty members with whom you are particularly interested in working.  Please include relevant research experience here.


The Alumni Relations Office, in an attempt to foster improved communication with our alumni, requests the following information from those applicants who are related to a graduate of our University.

If applicable, please list a relative who graduated from Des Moines University.

Relative Name:
Address:
Relationship:
Program Graduated From:   Year of Graduation:
If additional relatives have graduated from this school, please list in the additional information comment box below.

Have you ever applied to other DMU programs? Yes   No
Have you ever, or are you currently attending Des Moines University?    Yes   No  
If yes, what program? Dates of enrollment
Did you earn a degree from DMU?  Yes   No     If yes, what year
Have you ever attended a medical/professional school? Yes   No
If you answered "Yes" above, please state reason for leaving:
Name of institution:

How did you learn about Des Moines University? 
(check all that apply) 
 College advisor  Direct mail  Internet/Website 
Newspaper advertising Radio advertising   Recruiting/College Fair 
Referred by current DMU student,  
Referred by DMU alumnus,   
Other
 
APPLICATION FEE PAYMENT (Your application will not be reviewed until the $45 application fee is received.) For your convenience, you may pay online.
Cardholder name:
Credit card type:
Credit card number: 
3 or 4 digit card security number: 
  How to find your security code number:
On a Visa, Discover or MasterCard, please turn your card over and look in the signature strip. You will find (either the entire 16-digit string of your card number, OR just the last 4 digits), followed by a space, followed by a 3-digit number. That 3-digit number is your security code number. On American Express Cards, the security code number is a 4-digit number that appears above the end of your card numbers.
Expiration date:   

If you have any questions or concerns regarding payment, please call our accounting office at (515) 271-1530.


CERTIFICATION

I certify that all statements in this application are complete and true. If any of my statements are incomplete or false, I understand and acknowledge that my application for admission may be denied for that reason. Further, if the incompleteness or falsity of any of my statements is discovered after my matriculation, I may be subject to discipline up to and including dismissal from the program. For the purpose of determining admission only, I consent to and authorize any educational institution which I have previously attended to release academic and/or disciplinary information to Des Moines University.

Accepted students will be required to complete a criminal background check prior to matriculation. 

As part of building the DMU family, we may release your name, telephone number and colleges attended to Des Moines University alumni.

By submitting this application, I am agreeing to this certification.

PLEASE BE SURE to print a copy of this form for your personal records.

Please have your letters of recommendation

sent to the following address:

 

Des Moines University

MS Admission

3200 Grand Avenue

Des Moines, IA  50312