Department of Physical Therapy DPT/PHD Program Application

This form is to be used by students currently enrolled in Marquette University's DPT program that wish to pursue a Ph.D. in Exercise and Rehabilitation Science.

If you need any assistance completing this form, please contact the Graduate School at (414) 288-7137.

Student Information

First Name*

Preferred First Name

Middle Name

Last Name*

Previous Last Name

Birthdate*

Sex*

Which of the following best describes your gender?*

Gender Identity

What are your pronouns?* Examples: She/Her; He/Him; They/Them

Country of Citizenship*

Current Visa Status*

Social Security number*

Permanent residents and visa students must submit a copy of a green card, visa, or other residency document to be approved for registration.*

Contact Information

Email Address*

Mailing Address*

Country

Street

City

Region

Postal Code

Phone number*

Graduate School Plans

Program*

Degree*

When do you intend to begin Ph.D. courses?

Entry term*

Entry year*

References

Include the names and contact information for two references who can speak to your ability to be successful in a Ph.D. program. Your references are not required to submit a recommendation letter, but may be contacted by the Program Director to speak on your behalf.

Both references should be Marquette University faculty or instructors.

Reference 1:

First Name

Last Name:

Phone:

Email:

Reference 2:

First Name

Last Name:

Phone:

Email:

Supporting Documents

Upload your Undergraduate Transcripts

Submit a copy of your bachelor's degree transcript.

Upload your Resume/CV

Upload your Statement of Purpose.

Submit a document of no more than 500 words addressing your purpose for applying to the program, including specific research interests; your ability to successfully complete the program; and your short and long term goals.

Certification Agreement

I certify that the information given on this application is complete and correct to the best of my knowledge. I understand that any falsification of my records may be cause for the university to void either my admission or registration or to take other appropriate action. I understand that some degrees, programs, and/or courses may require me to submit to criminal background checks and/or drug testing. I further understand that the results of those checks and/or tests may affect my eligibility to continue in that degree, program, and/or course.

In place of your signature, please type your full legal name*

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Department of Physical Therapy DPT/PHD Program Application

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