Rehabilitation Counseling Program
Application Monitoring System

Please provide the following contact information:

Name
Social Security #
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Indicate the purpose of your application:

I am applying for admission to the degree program.
  I am applying to take courses on a non-degree basis.

If you are applying for non-degree admission, 
please type in the name/numbers of the RHAB 
courses you wish to take in the box below.  You can
check the course titles and descriptions by clicking here.
Then use your browser "Back" button to return to this
page.

Enter the date when you are submitting an electronic application to the Graduate School:

-- mm/dd/yy

Please read the graduate application information carefully.  Note that the Graduate School will not begin to process your electronic application form until the application fee has been received.  Until the fee is received, your form with the information will remain in a computer file which only you can access.