Applicant Information: Name: Current Address: Mail Address (if different from above): Home Phone: Work/Cell Phone: E-mail Address: Emergency Contact: Name: Telephone Number: How did you hear about us? Have you previously applied to CADH? YesNo If yes, when? Have you previously enrolled at CADH? YesNo If yes, when? Enrollment and Educational Information: Please list your most recent school first. School 1 School/Institution: Address: Program: Highest Educational Level Completed: Year Entered: Year Left: School 2 School/Institution: Address: Program: Highest Educational Level Completed: Year Entered: Year Left: If you do not currently meet all the educational requirements, please contact us to find out how you can complete them. Please read carefully: By submitting this form, I certify that the information on this application is accurate and complete, and I understand that all required credentials must be submitted before a final admissions decision will be made. I understand that it is my responsibility to ensure all supporting documentation has been submitted to the school. I authorize CADH to maintain all my records and understand that these records that have been received by CADH in support of my application will become the property of CADH and may not be reproduced or returned.