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Doctor of Acupuncture and Oriental Medicine (DAOM) 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.

Institution 1

Institution 2

Institution 3

Institution 4

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. *

Personal Statement

State why you are interested in becoming a Doctor of Chiropractic, Licensed Acupuncturist, Massage Therapist, or taking accelerated science courses through the Institute of Science. *Minimum 300 Words.*

For the Bachelor Completion Program, please write a three page essay on your interest in attending SCU’s BCP and include your understanding of integrative medicine, integrative health, and the future opportunities and need for interprofessional practice.

Demographic Information

Non-US Citizens:


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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