CAHP

To inform you of important updates and better report statistical information for accreditation purposes, we ask that you share some information with us. Fields marked with an * are required.

Information provided on this form will not impact any application or review decision.

Program of Interest:*

Anticipated Admission Year:*

How Did You Hear About Us?*

What date did you attend, or plan to attend, a First Step Session?

Which location was the session:

First

Last

Name:*

Current Address

Street, PO Box, etc:

State:

Zip:

City:

Country:

State of Residence:

Email:*

Phone:

Birthdate:
(mm/dd/yyyy)

Gender:

Female Male

Name

City

State

Country

Graduating High School:

Add	Name	Year From	Year To	Major	Total Credits	Degree Earned
College or University

U of MN Student ID:

If you have attended or worked at the U of MN anytime since 2000

(OPTIONAL)

Citizenship Status:

Visa Type:

Race/Ethnicity:
(check all that applies)

Are You Hispanic or Latino Yes No
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Parent/Guardian A

Parent/Guardian B

Education of Parents/Guardians:

Have any family members ever attended or been employed by the University of Minnesota: Yes No