Program Application Form

Desired Intake? *
Are you a DPM ? *
Are you a resident of Saint Kitts / Nevis ? *
A non-refundable application fee of US $150 must accompany this form.  If all the information is not completed in full, the processing of your application may be delayed.  Please mail the completed Application Form and include  a copy of your Passport.  If you do not have a Passport please include a copy of your birth certificate and a Government issued Photo ID as well as 4 Passport photos to: IUHS P.O. Box 1149 Hightstown, NJ 08520
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Are you applying as a Transfer Student? *

PERSONAL INFORMATION


Permanent Address:

Mailing Address (If different) :

CONTACT INFORMATION


Form Login Account (optional)
New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.
If you would like to print a blank application please click here.