APPLICATION FORM
for entry to the postgraduate
DIPLOMA & CERTIFICATE
IN PUBLIC HEALTH (DPH/CPH)
At the
University of Otago, Wellington
Te Whare Wānanga o Otāgo, Te Whanga-nui-a-Tara
Name of applicant:___________________________________
Student ID No: (if known)_____________________________
Date of application:___________________________________
Due dates for receipt of applications:
First Semester
2013:
Second Semester 2013:
18 January 2013
1 June 2013
NB: If you are not a New Zealand Citizen or Resident you must enrol as an
International Student. Prospective International Students must apply to the
International Office for admission to study at the University of Otago before submitting
this form.
Information: http://www.otago.ac.nz/international/index.php
Contact:
[email protected]
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Please complete pages 2 - 7 by ticking or writing in the spaces provided
Sign page 7
Return application together with your essay to:
Mary Anderson
Postgraduate Administrator
Department of Public Health
University of Otago, Wellington
PO Box 7343
Wellington South 6242
If you have any queries, please phone Mary Anderson on
(04) 918 6040
Or email: [email protected]
Personal Information
 Name: ______________________________________________________
Mr/Mrs/Ms/Miss/Dr
male
First Names
Last Name
female

Gender:

Telephone:___________________(work)________________________(home)

Cellphone:________________________

Email:_______________________________________________________

Are you a New Zealand College of Public Health Medicine registrar?
yes
no
NB: Please check closing dates for application at: http://www.populationhealth.org.nz
Do you consent to your email address being made available to other Public Health students if
requested?
yes

no
Are you currently in paid employmnet?
yes, full-time
yes, part-time
no
Do you have your employer’s consent to participate in the DPH Programme?
yes
no
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
Citizenship status:
 New Zealand Citizen Permanent resident
International student*
 other - please specify
________________________________________________

Applicants who are not New Zealand residents must contact the International Office at
[email protected] before submitting this application.
Which ethnic group do you belong to?
Mark the space or spaces that apply to you.
 New Zealand European
 Māori
 Samoan
 Cook Island Māori
 Tongan
 Niuean
 Chinese
 Indian
 other (such as Dutch, Japanese,
Tokealuan). Please state:
____________________________________________
____________________________________________
3
Tertiary Qualifications
Please indicate all university degrees or diplomas, or other tertiary qualifications
(e.g.certified nurse, polytechnic diploma) which you have gained in the table below.
A general requirement for entry into postgraduate public health courses is a good
undergraduate degree, diploma, or professional qualification, which would
normally equate to a B average overall, Note also any qualification you expect to
gain in 2012.
Degree, diploma, or other
course
Institution
Country
Year of graduation
Awaiting Results:
English Language
Graduates from a non-New Zealand University, whose first language is not English, are
required to show evidence of adequate proficiency in English. The IELTS score for
University of Otago Postgraduate papers in Public Health is 7.5
My IELTS results are attached
yes
no*
*Please explain________________________________________________________
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Employment History
(NOT REQUIRED IF COMPLETED ON e:Vision) Please give details of your
employment experience (starting with your most recent employment):
Personal Introduction
Applicants for DPH, DPH & CoP (physician training exempt), please write a short
(300 to 500 word) introduction which outlines your interest & experience (as
appropriate) in public health and a main reason for wanting to do postgraduate
study (eg. Professional advancement, new direction, support for other interests
etc.). Please type and attach to this form. (Not required if completed on e:Vision)
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Course Plans
Which qualification are you enrollng for?
□ Diploma of Public Health, DPH
□full-time
□part-time
(Consists of four papers of which two are compulsory)
□ Endorsed Certificate of Public Health, CPH
(Consists of any two DPH papers with endorsed option)
Endorsement__________________________________________________
Refer list on following web site link:
http://www.otago.ac.nz/wellington/departments/publichealth/postgraduate/otago016784.html
□ Certificate of Proficiency, CoP :
1
(one paper only)
□ one paper as part of a qualification from another university (eg. Massey MA,
Victoria MDevSt)
Please specify_________________________________________________________
____________________________________________________________________
□ a Public Health paper as part of another Otago qualification
Please specify_________________________________________________________
(e.g. MHealSc, MSc)
When do you plan to start?
Year:_________________________
Semester:________________________
MPH Plans
Students may proceed to MPH after completing the DPH with an average mark of
at least 73% (or the equivalent mid B and B+ grades from an equivalent qualification at
another university).
Would you be interested in proceeding to MPH?
□yes □no □not sure
MPH applications are on a separate from. This can be submitted once you know your
marks. (see our website for procedure to progress to MPH)
1 This
is awarded to a single paper which can stand alone or be converted retrospectively to become
part of another qualification. It is also awarded for an Otago paper which is part of a qualification
at another university.
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Planned DPH/MPH papers
Please indicate your desired course in the table below by ticking the approproate
cells. If you are not sure which paper to take indicate your choice with a query(?).
Notes:
 An interview may be required before course approval is granted.
 Two papers are considered a full-time course for a semester. There are two
semesters in a full year.
 All DPH students must take PUBH701 (Epidemiology and Biostatistics) and
PUBH702 (Society, Health and Public Policy), plus TWO other PUBH papers
from the list.
 Full-time students take PUBH701 and one other paper in the first semester, and
PUBH702 and one other paper in the second semester.
 Part-time students take one paper each semester, for each of two years. Part-time
students are advised to take PUBH 701 and PUBH702 in their first year
 Students planning to enrol for MPH by dissertation will take SIX papers (4 DPH
& 2 MPH) in total.
Paper
Description
2013
2014
Semester 1
PUBH701
Epidemiology and Biostatistics (compulsory)
PUBH705
Health Promotion
PUBH706
Health Systems
PUBH708
Social Research Methods
Semester 2
PUBH702
Society, Health and Public Policy (compulsory)
PUBH703
Health and Environment
PUBH704
Health Economics
PUBH709
PUBX710
Hauora: Maori Health Issues
(Distance
Taught)
Public Health Law and Public Health Ethics
PLEASE NOTE the compulsory papers (PUBH701 and PUBH702) are at times over
subscribed so if you delay enrolment in these until late in the preceding semester you may
not be able to proceed.

Substitute papers must be approved by the Public Health Board of Studies as having
relevance to health and no significant overlap with another qualification.
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There are two requirements for enrolment:
1.
You must submit this application to the address on page 2 to study in Wellington
2.
You MUST register with the University of Otago at :-
www.otago.ac.nz/OnlineReg
(Please indicate if completed on line)
□
Final date for Semester One registration is 10 December 2012, otherwise you may incur a
late fee.
N.B: To gain access to the Medical Library, Blackboard or other electronic resources you
will need an ID card. Please remember to apply for your ID Card at the same time as
your registration.
Signature of student:_______________________________________________
Date:_________________________ Otago ID No:_______________________
(if already studied at Otago)
Please let us know where you heard about the DPH/CPH/MPH programme?
Have you ever taken part in any of the University of Otago Wellington Summer School
short courses (preparatory, extension & professional development topics)?
(see http://www.uow.otago.ac.nz/academic/dph/postgrad/index.html)
If yes please name the course(s)_____________________________________________
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