UAA Didactic Program in Dietetics(907) 786-1276 Phone

UAA Didactic Program in Dietetics(907) 786-1276 Phone

UAA Didactic Program in Dietetics(907) 786-1276 Phone

3211 Providence Drive, Cuddy Hall 126(907) 786-1402 Fax

Anchorage, AK 99508

UAA DPD Application for Admission

All application material, including letters of recommendation, must be provided in one packet. Application must postmarked no later thanFebruary 15. The application must be typed. You may add or delete lines as needed.

Name______

LastFirstMIPrevious Name (s)

UAA Student ID #___ Primary Phone Alternate Phone ______

Email Address______

Mailing Address______

Recommendations: Please list the two individuals who will be submitting letters of recommendation. Letters from relatives will not be accepted.It is strongly recommended that letters come from individuals who can speak to your academic and/or work skills (supervisor, instructor, etc.). Recommendations must be included with the application packet. They must be in a sealed envelope with the signature of the person writing the recommendation over the seal. This signature must match the signature on the letter.

Name Position Telephone Number

______

______

Honors and/or Extracurricular Activities:

List organizations, clubs, appointed or elected offices held, scholarships, honors, and certifications received post high school. Include dates.

Professional Organization Memberships:

List any professional organizations of which you are a member if applicable.

Community Service / Volunteer Experiences:

List any community service or volunteer activities you have participated in. Please indicate the approximate total number of hours of your involvement.

Name of Organization / Activities completed/participated in / Name of contact person at organization / Total hours volunteered / served

PaidWork Experiences in the Past Five Years:

List all PAID work experience, beginning with the most recent. Please note: it is ESSENTIAL that you include hours per week and number of weeks/months OR total number of hours so your application can be fairly evaluated.

Name of Employer/OrganizationPosition Title Start Hours/Week
End Dates
1.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:
2.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:

Work experiences in the past 5 years: (continued)

Name of Employer/OrganizationPosition TitleStart &Hours/Week Paid or
End Dates(or total hours) Volunteer
3.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:
4.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:
5.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:
6.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:
7.
Supervisor’s Name and Title: Email:
Phone:
Key Responsibilities:

UAA DPD Prerequisite Courses:
List all courses required for admission to the UAA DPD as outlined in the UAA DPD Policy and Procedure Student Handbook. All courses listed must appear in your UAA Transcript. Grades will be verified; listing them here assists with that process.

Required Course / Semester and Year Taken / Grade Earned / If a course was transferred to UAA to meet this requirement, please list the name of the institution and the title of the course.
BIOL A111
BIOL A112
CHEM A105
CHEM A105L
CHEM A106
CHEM A106L
DN A100
DN A203
Humanities GER (3)
Humanities GER (3)
MATH A107 or higher
Oral Comm. GER
PSY A111 or SOC A101
Written Comm. GER (3)
Written Comm. GER (3)
Other DN Courses from UAA (list all DN courses taken in rows below; a minimum of 6 credits is required)

Video Presentation

As part of the DPD application, you are required to provide a video recorded presentation addressing specific questions. This provides the Selection Committee an opportunity to learn more about you. The presentation must meet the following requirements:

  1. Must be accessible via the internet. You may limit viewers, but access must be given to the DPD Selection Committee. An unlisted link on You Tube is one easy option for providing web access to the video while still limiting access. The link will only be provided to the Selection Committee members.
  2. The presentation must not exceed 7 minutes in length.
  3. Professional video quality is not expected; the type of quality obtainable from a mobile device is sufficient. You will want to make sure the audio is clearly heard and understood.
  4. The video must contain your own image and voice.
  5. The video must address each of the questions below.

Questions to address in your presentation:

  1. Briefly introduce yourself to the committee.
  2. What made you choose to major in Dietetics?
  3. What strengths or skills will you bring to the Dietetics program?
  4. What is an area in which you feel you need further growth or development?
  5. How do you feel your volunteer and/or work experience or extracurricular activities will help you be successful in the Dietetics program?
  6. As you know, the majority of this degree is delivered online. What types of strategies do you use to be successful in online classes?
  7. What motivates you to put forth your best effort?
  8. Tell us about a significant accomplishment you’ve had and what made that meaningful.
  9. Is there anything else you would like to ask us or share with us?

Provide the URL to your video presentation here (indicate if there is any type of password required for access):

______

It is highly recommended that you have someone verify that your video is accessible from a user/computer other than yourself.
The following must be accessible by Dietetics and Nutrition program faculty in UAOnline or submitted with this application to be eligible for the ranking process:

  1. Verification of completion of required prerequisite courses and required GPA (see UAA DPD Policy and Procedure Student Handbook).
  2. All courses being used to satisfy prerequisite requirements must be evident in your UAA transcript. If you are utilizing transfer credits, you will need to allow time for these to be evaluated by the Registrar’s office.
  3. This application form.
  4. Twoprofessional (not personal) letters of recommendation using required form (see UAA DPD website).
  5. Letters of recommendation must be included with your application packet. Letters must be in a sealed envelope with the signature of the person writing the recommendation over the seal. This signature must match the signature on the letter.
  6. Individuals writing letters should be able to speak to your academic and/or work performance.
  7. Letter of Application addressing the following criteria:

a.Why you are pursuing the profession of dietetics

b.Your strengths and weaknesses related to your professional goals

c.Expectations from the UAA DPD and your academic/career plans

Please use this opportunity to let us get to know you and your professional goals and interests.

  1. URL for your video recorded presentation.

Application Process Requirements:

  1. All required application materials must be postmarked by February 15. Late applications will not be accepted. All application materials, including letters of recommendation, must be submitted at one time in the same application packet.

ALL INFORMATION IN THIS APPLICATION IS COMPLETE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.

Applicant SignatureDate

Please return this application to:Kendra Sticka

UAA DPD Program Director

Culinary Arts, Hospitality, Dietetics & Nutrition

3211 Providence Drive

Anchorage, AK 99508

It is the policy of the Board of Regents of the University of Alaska (01.01.07), that in accordance with federal and state law, discrimination against any individual because of race, color, religion, national origin, age, sex, Vietnam era or disabled veteran status, physical or mental disability, changes in marital status, pregnancy or parenthood is prohibited. Decisions affecting individuals shall be based on individual’s qualifications, abilities and performance as appropriate.

For complaints of unlawful discrimination based on race, color, religion, national origin, age, sex, Vietnam era or disabled veteran status, physical or mental disability, changes in marital status, pregnancy or parenthood, contact the Office of Campus Diversity and Compliance at 786-4680.

UAA is an EO/AA Educational Institution

Updated 5/12/14Page 1

Top View