Make a Payment - Application Fee Step 1 of 2 50% Student InformationName* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern 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CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Enter Email Confirm Email Application program area of study:*Please make sure the correct program area of study is selected.Select ProgramDoctor of Medical SciencePhysician Assistant Psychiatry CertificateMaster of Science in Speech-Language PathologyDoctor of Occupational Therapy (entry-level)Doctor of Speech-Language Pathology (SLPD)Doctor of Philosophy in Health Sciences--Athletic TrainingDoctor of Philosophy in Health Sciences--Health Promotion & WellnessDoctor of Philosophy in Health Sciences--Healthcare Leadership & AdministrationDoctor of Philosophy in Health Sciences--Healthcare Professions EducationDoctor of Philosophy in Health Sciences--Human & Sport PerformanceDoctor of Philosophy in Health Sciences--Integrated Health SciencesDoctor of Philosophy in Health Sciences--Neurologic RehabilitationDoctor of Philosophy in Health Sciences--Orthopedic Sports ScienceDoctor of Philosophy in Health Sciences--Pediatric ScienceMaster of Science in Nursing - Family Nurse PractitionerMaster of Science in Nursing - Psychiatric Mental Health Nurse PractitionerMaster of Science in Nursing - Family Nurse Practitioner & Psychiatric Mental Health Nurse PractitionerMaster of Science in Nursing - Family Nurse Practitioner & Emergency Nurse PractitionerDoctor of Nursing Practice (Post-Master’s)Post Bachelor's Doctor of Nursing Practice (Family Nurse Practitioner)Family Nurse Practitioner Certificate (Post-Master’s)Psychiatric Mental Health Nurse Practitioner Certificate (Post-Master’s)Family Nurse Practitioner Certificate & Psychiatric Mental Health Nurse Practitioner Certificate (Post-Master’s)Family Nurse Practitioner Certificate & Emergency Nurse Practitioner Certificate (Post-Master’s)Emergency Nurse Practitioner Certificate (Post-Master’s)Post-Professional Doctor of Occupational Therapy--Advanced PracticePost-Professional Doctor of Occupational Therapy--LeadershipPost-Professional Doctor of Occupational Therapy--AgingPost-Professional Doctor of Occupational Therapy--EducationPost-Professional Doctor of Occupational Therapy--Hand TherapyPost Professional Doctor of Occupational Therapy--Health & Wellness CoachingPost-Professional Doctor of Occupational Therapy--PediatricsPost-Professional Doctor of Occupational Therapy--Assistive TechnologyOT School-Based Practice CertificateOT Assistive Technology Practice CertificateOT Leadership Practice CertificateOT Pediatric Practice CertificateTransitional Doctor of Physical Therapy in Pediatric ScienceMaster of Science in Health Science--Health & Wellness CoachingMaster of Science in Health Science--Functional NutritionMaster of Science in Health Science--Sports PerformanceMaster of Science in Health Science--Rehabilitation ScienceMaster of Science in Health Science--Healthcare AdministrationMaster of Science in Health Science--Healthcare Professions EducationMaster of Science in Athletic Training PracticeHealth & Wellness Coaching CertificateHealthcare Leadership Administration CertificateHealthcare Professions Education CertificateEmergency & Primary Care for Athletic Trainers CertificateFunctional Nutrition CertificateMaster of Science in Addiction CounselingMaster of Science in Clinical Rehabilitation CounselingMaster of Science in Marriage, Couples & Family CounselingMaster of Science in Mental Health CounselingMaster of Science in School CounselingMaster of Science in Mental Health & School CounselingMaster of Science in Addiction & School CounselingMaster of Science in Clinical Rehabilitation & School CounselingMaster of Science in Marriage, Couples & Family & School CounselingMaster of Science in Addiction & Mental Health CounselingMaster of Science in Clinical Rehabilitation & Mental Health CounselingMaster of Science in Marriage, Couples & Family & Mental Health CounselingSchool Counseling CertClinical Mental Health Counseling CertAddictions Counseling CertificateMarriage, Couples & Family Counseling CertificateClinical Rehabilitation Counseling CertificateNon-Degree SeekingPayment InformationApplication Fee* Price: Total $0.00 Please Review your total below.Your account will be charged this amount upon form submission.Transaction Total $0.00 Billing InformationBilling Name* Billing Address* Same as previous Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Month010203040506070809101112 Expiration 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