Certificate in Chinese Herbal Medicine Application Form

APPLICATION FORM FOR:
1) MASTER OF ACUPUNCTURE AND HERBAL MEDICINE (MAHM) program; or

2) DUAL ENROLLMENT MASTER OF ACUPUNCTURE & HERBAL MEDICINE AND DOCTOR OF ACUPUNCTURE & HERBAL MEDICINE (MAHM/DAHM) program
Student Type (check all that apply)*

MAHM/DAHM ApplicantMAHM Only ApplicantTransfer Applicant
Name*

First NameLast Name
Preferred Name
Date of Birth*

MonthDayYear
Phone Number*
Please enter a valid phone number.
Social Security Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How did you hear about the MAHM or Dual Enrollment MAHM/DAHM program?*

Daoist Traditions StudentPrint adOpen House eventAcupuncturistHealthcare ResearchFriend or colleagueJeffrey Yuen classOther
If other, please specify how you heard about us:
Uploads for both MAHM and Dual Enrollment Applicants
Copy of driver's license or other government identification*

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Photo of yourself (headshot/selfie)*

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Admissions Essay of 750-1000 words: Tell us how you became interested in Chinese Medicine. What do you feel are the most important qualities in being a healthcare practitioner? What are your professional goals upon completion of the program? Essays are evaluated based on content and standard writing conventions.*

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English Language Competency Exam scores (if applicable)

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Current curriculum vitae (CV)*

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ALL APPLICANTS: The following items must be mailed directly to Daoist Traditions College, 382 Montford Ave., Asheville, NC 28801:

1) Letter of reference from a person with whom you have a professional relationship, e.g. employer/teacher. Letter should address your ability to be effective in a professional setting, commitment to personal endeavors, integrity, maturity level, and healing presence. 2) Proof of immunizations - due within 30 days of enrollment.
Required submissions for MAHM Applicants Only (must be sent directly to Daoist Traditions College from the institution)

Official college transcripts: minimum of two years and 60 semester credits or 90 quarter units of general education at the baccalaureate level from an institution accredited by an agency recognized by the U.S. Secretary of Education, or an equivalent International entity.

Required submissions for Dual Enrollment (MAHM/DAHM) Applicants Only (must be sent directly to Daoist Traditions College from the institution)

Official college transcripts: minimum of three years and 90 semester credits or 135 quarter units of general education at the baccalaureate level from an institution accredited by an agency recognized by the U.S. Secretary of Education, or an equivalent International entity. Education must include undergraduate or professional level courses in biology and psychology to ensure readiness for doctoral level coursework. This requirement may be met by one of the following means: • Completion of courses in previous undergraduate education. Transcripts must be sent directly to Daoist Traditions from the institution; • Completion of College level Examination Placement (CLEP) or American Council on Education (ACE) credit courses with the minimum credit-granting scores achieved. Scores must be sent directly to Daoist Traditions from the College Board; or • Completion of the following professional level certificate courses, via Coursera.org, a massive open online course (MOOC) provider: The Little Stuff: Energy, Cells and Genetics (University of Colorado Boulder) and Introduction to Psychology (Yale University). Certificate of completion must be forwarded to Daoist Traditions.
Required submissions for Transfer Applicants (transferring from a Chinese Medicine/acupuncture college)

Applicants who would like to transfer previous Chinese medicine education must submit the following materials, in addition to the application materials for the program of study: □ Syllabi outlining the course content for each course you wish to transfer. Weblink can be provided. □ Your letter of reference should be from a previous CM/acupuncture instructor. Send materials to admissions@daoisttraditions.edu.
Application Fee of $100.00 (required for ALL Applicants)

My Products

Application Fee - MAHM program and Dual Enrollment MAHM/DAHM programApplication fee for the MAOM program and the Dual Enrollment MAOM/DACM program

$100.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

I certify that the information I have provided above are true to the best of my knowledge without any malice or any intention to commit acts of misrepresentation.

I am aware that any false, misleading, or deceptive information provided may lead to withdrawal, expulsion, or any disciplinary action which may be dealt with by the school's authorities.
Name of Applicant

First NameLast Name
Applicant's Signature*

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Date Signed by Applicant

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APPLICATION FORM FOR:

1) MASTER OF ACUPUNCTURE AND HERBAL MEDICINE (MAHM) program; or

2) DUAL ENROLLMENT MASTER OF ACUPUNCTURE & HERBAL MEDICINE AND DOCTOR OF ACUPUNCTURE & HERBAL MEDICINE (MAHM/DAHM) program

EDUCATION

In case of emergency, notify:

English Competency

Uploads for both MAHM and Dual Enrollment Applicants

ALL APPLICANTS: The following items must be mailed directly to Daoist Traditions College, 382 Montford Ave., Asheville, NC 28801:

Required submissions for MAHM Applicants Only (must be sent directly to Daoist Traditions College from the institution)

Required submissions for Dual Enrollment (MAHM/DAHM) Applicants Only (must be sent directly to Daoist Traditions College from the institution)

Required submissions for Transfer Applicants (transferring from a Chinese Medicine/acupuncture college)

Application Fee of $100.00 (required for ALL Applicants)