Christopher Newport University | Biology, Chemistry and Environmental Science

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Health Profession Intent Form


CNU students: Register or update your intent to pursue a Health Profession in three easy steps.

1.	Complete the following information to register your interest in a Health Profession.	2.	Update your information as often as necessary to remain current and maintain your status.	3.	After your original submission, fill in only your name, CNU student ID# and email address (preferably your CNU email address), and any information updates. If your semester hours are not updated each semester, your intent will become inactive and you will not receive important prehealth updates and information!

*Fields marked with indicate required information.**

*First Name:	*Last Name:
*Email Account(s):	*CNU Student ID:
Local Phone: (757) -	Cell Phone: ( ) -
Residence Hall:	MailBox Number:
OR
Local Address:	City, State, Zip:

Semester Entering CNU:	Year:
Major:	Semester Hours Completed: Please keep current each semester
Minor:
Check all that apply: Honors Biology Degree w/ Distinction President's Leadership Program Beta Beta Beta Other:
Prehealth Area of Interest:
Pre-Med Pre-Dental Pre-Pharmacy	Physician's Assistant Physical Therapy Pre-Vet Other:

Permanent Home Address:
City: State: Zipcode:

Additional Comments/Information: