MSPA Application

MSPA Application


Permanent Address

Current Address

Contact Information

Emergency Contact

Academic Information

List in chronological order all post-secondary institutions you have attended regardless of length of attendance and even if no work was completed. Include previous attendance at this institution and any correspondence or extension courses taken. Attach an additional sheet of paper, if needed. (Official high school or GED and all college or university transcripts must be sent to the Office of Admissions. Failure to list all colleges or universities in which you have been enrolled, regardless of status, may disqualify your application.) For Accelerated Science Courses (Institute of Science), list your colleges or universities only if registering for courses with pre-requisites.

Extra-Curricular Activities

Briefly describe your involvement in any extra-curricular activities in which you participated. Please include any scholarships or scholastic honors/awards, etc. received. Maximum 250 Words. *

Other Information

Cash PlanFinancial Aid PlanMillitary or Government PlanPrivate Education LoanPayment PlanOther


The statements I have made are correct to the best of my knowledge. I understand that any misrepresentation or omission of facts requested on this application is cause for disqualification of the application process or for dismissal from the University. If admitted, I agree to conform to all rules and regulations of Southern California University of Health Sciences.

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