Environment & Public Health Risk Free Evaluation

Find out if you're eligible for the Environment & Public Health program before paying the $40 application fee.

HOW?

Complete this form.
Submit your unofficial undergraduate transcript. (We'll provide instructions on the next page.)
We'll review your transcript and determine if you qualify to take the course this year.
You'll receive an email about your eligibility.

* Indicates required field

First Name:*	This field is required.
Last Name:*	This field is required.
Job Title:
Company:
Industry:
Address:*	This field is required.
City:*	This field is required.
State/Province:*	This field is required.
Zip Code:*	This field is required.
Country:
Phone Number:*	This field is required.
Fax Number:
Email Address:*	This field is required.
Do you want to receive email notifications about EPH?*	Please select an item.
Please describe your current employment status.*	Please select an item.
Have you earned a college degree?*	Please select an item.
If yes, please indicate type of degree earned.
Additional Comments or Questions:
How did you hear about EPH?
Please Specify (website, professor, school, event, etc.):