UC CPD Application

Dietetics Coordinated Program Application

Application Deadline - January 25, 2020 by 5pm
Read and follow the instructions carefully prior to submitting your application.

All applicants must submit their completed application by January 25, 2020. Please make sure to review the Core Knowledge and Competencies for the RDN and Coordinated Program in Dietetics Essential Program-Related Functions.

Applications will not be reviewed until all documents have been submitted to the admissions committee. Please note that once your application has been submitted, no additions or changes can be made.

If you have any questions or issues, please email thremla@ucmail.uc.edu.
Read and Understand the instructions. *

Yes, I Agree
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. Please use proper spelling, capitalization and punctuation.
1. Personal Information:

Tell us about yourself
Full Name *

First Name Middle Name Last Name Suffix
Birthdate: *

Month Day Year
Mobile No. : *

Area Code Phone Number
E-mail : *

Current Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Permanent Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

M# *
2. Applicant's Resume
Make sure that your resume includes the following items (bullets are acceptable):
1. List those job skills acquired during your employment that will benefit you during the supervised practice and in the field of dietetics.
2. Volunteer Activities – Only indicate volunteer activities of substance and duration. Please do not include one-time activities of only a few hours.
3. List those skills acquired during your volunteer experiences that will benefit you during the supervised practice and in the field of dietetics.
4. Awards/Scholarships, Leadership, Membership
Your resume should include the following items: extracurricular activities, work experience, volunteer experience, and honors/awards. *

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Please upload a PDF copy of your resume Cancel of
3. Paid Employment:

Job Title

Employer

Start Date

End Date

Average # of Hours/Week

Seasonal Work (y/n)

4. Education Information:

Previous and Current College/Universites

Name

Start Year

End Year

Quality Points

Credit Hours Earned

Institution 1

Institution 2

Institution 3

Institution 4

Cumulative Quality Points
Cumulative Credit Hours
Cumulative GPA
Official Transcripts for all colleges and/or universities attended must be submitted with the CPD application. University of Cincinnati transcripts can be unofficial versions downloaded from your Catalyst account. Even if none of your former college or university credits transferred to UC’s dietetics program, you must still submit an official transcript from that college/university and list them in the table above. *

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Please upload a PDF copy of your transcripts (merge multiple files into one document) Cancel of
5. DPD Coursework:

Instructions:

For classes taken during on the quarter system, multiply the # of credit hours by 0.66 and place that value in the # of Credit Hours field.

Please select the appropriate grade point value for each class based on the grade you earned in the table below.

Grade Earned	Grade Points
A+, A, A-	4.0000
B+, B, B-	3.0000
C+, C, C-	2.0000
D+, D, D-	1.0000
ServSafe Only	Waived
AP Credit/College Credit	Waived

# of Credit Hours

Grade

Planned Completion Term

Intro to English Composition

Intermediate Composition

Intro to Psychology

Food and Culture or Sociology

Intro to Biology

Microbiology for Health Professionals

Anatomy & Physiology I

Anatomy & Physiology II

GOB Chemistry I

GOB Chemistry Lab I

GOB Chemistry II

GOB Chemistry Lab II

Survey of Biochemistry I

Survey of Biochemistry II

Intro to Statistics

College Algebra

Research Methods in Health Sciences

Personal Nutrition

Lifecycle Nutrition

Food Science I

Food Science II

ServSafe®

Cooking for Disease Prevention & Treatment

Advanced Nutrition I

Advanced Nutrition II

Institutional Management

Community Nutrition

Nutrition Care Planning

Medical Nutrition Therapy I

Medical Nutrition Therapy II

Nutrition Counseling & Communication Skills

DPD GPA
DPD Quality Points
DPD Credit Hour Total
6. Letters of Recommendation:

List the names of the 3 individuals who will complete your recommendation forms (2 instructors or professors, plus 1 work manager or supervisor). Do not list more than three.
Faculty Recommendation 1:
Name: *

First Name Last Name
Email: *
example@example.com
Phone Number: *

Area Code Phone Number
Title: *
Faculty Recommendation 2:
Name: *

First Name Last Name
Email: *
example@example.com
Phone Number: *

Area Code Phone Number
Title: *
Work Supervisor/Manager Recommendation:
Name: *

First Name Last Name
Email: *
example@example.com
Phone Number: *

Area Code Phone Number
Title: *
7. Short Answer Questions
A. What would you like the CPD Admissions Committee to know about you? Discuss your personality and interests, as well as each of the following bullet points.
- Self-direction
- Interpersonal skills
- Leadership ability
- Overall preparation for supervised practice
- How you work under pressure and your coping mechanisms
A.
B. What are the strengths that you will bring to the CPD? In what areas do you hope to improve upon?
C. The supervised practice portion of the program will require a large commitment of time (40 hours per week, generally Monday through Friday 8-5, although hours will vary depending on the rotation and preceptor’s work schedule), energy (homework assignments in addition to a 40-hour work week), and financial resources over a 10-month period.
- How will you address the time, energy, and financial responsibilities?
- What prior commitments (including UC athletics and/or paid employment), transportation issues, or other issues might affect your ability to fully commit to the supervised practice?
- Before responding to this question, please carefully review the materials CPD Essential Program-Related Functions and Core Knowledge and Competencies for the RD linked at the top of this application.
C.
D. The CPD has designated pediatrics and long-term care as its 2 areas of concentration. Interns must choose one of these 7-week rotations to complete during supervised practice. Indicate which area you prefer and the reason(s) why. If your preferred choice is not available, how do you feel about completing the alternative concentration?
D.
E. Why did you choose nutrition and dietetics as a career, and describe your reasons for applying for the Coordinated Program?
F. What are your professional goals after completing the requirements to become a Registered Dietitian Nutritionist?
8. Applicant's E-Signature
I understand that, if I am accepted into the Coordinated Program in Dietetics:

I must earn no less than a B- in the following NUTR courses: Nutrition Care Planning, and Medical Nutrition Therapy I and II. Failure to do so will result in dismissal from the CPD (and I will seek academic advising for transfer into the Dietetics or Food & Nutrition undergraduate program) or withdrawal of the conditional offer to complete the CPD;

I must maintain a minimum GPA of 3.0 for all subsequent semesters of study. If I do not maintain a 3.0 following the completion of the semester, I will be placed on program probation during the next semester. Upon calculating my combined GPA for the semester during which I did not earn a minimum 3.0 and the subsequent semester, I understand that I will be dismissed from the program if the combined GPA does not meet the minimum of a 3.0 average. Should the GPA fall below 3.0 in my last semester of didactic work, I understand that I will be dismissed from the program and I will seek academic advising for transfer into the Dietetics or Food & Nutrition undergraduate program;

I will be required to submit a federal and state background check prior to beginning supervised practice and, if offenses are found that prohibit me from entering supervised practice sites, I will be dismissed from the program. (A list of these offenses can be found on the Ohio Board of Dietetics website, although each individual rotation site has the right to include other offenses that will deny entry to an intern and may prevent the intern from completing supervised practice);

I will be required to complete the physical form in its entirety, including proof of recent vaccinations and TB testing, and will be required to be vaccinated against influenza at the appropriate time of the year;

I may be required to undergo a drug screen prior to entering a rotation site should the site request one; and

I will be required to produce proof of vehicle insurance prior to beginning supervised practice and again during the year when that insurance is renewed.

Further I understand that the CPD requires completion of a minimum number of hours of supervised practice. I also understand that this is an accredited competency-based program and, even if I have completed the hours, if I have not shown that I have successfully met the competencies, I will not be permitted to graduate from the program until remediation is completed (as per program policy). Only after I have demonstrated competence in every rotation will I have earned the right to graduate and be issued a CPD verification statement.
E-Signature: *
University of Cincinnati Notice of Non-Discrimination
Should be Empty:

Dietetics Coordinated Program Application

1. Personal Information:

2. Applicant's Resume

3. Paid Employment:

4. Education Information:

5. DPD Coursework:

6. Letters of Recommendation:

7. Short Answer Questions

8. Applicant's E-Signature