Wellness - Fisher Institute Departmental Application
The John and Janice Fisher Institute for Wellness and Gerontology, College of Applied Sciences and Technology, Ball State University, Muncie, Indiana, 47306 (765) 285-8259; (888) WELLBSU; (765) 285-8237 (fax)

The John and Janice Fisher Institute for Wellness and Gerontology is an extension of the University's pioneering efforts in health education, health promotion, and adult fitness. Defining wellness as a continuous, multidimensional process of self-development focusing on enhancing the mind, body, and spirit across the lifespan, the Institute is committed to improving the health and well-being of individuals, organizations, and communities. The mission of the Fisher Institute is to teach, investigate, and evaluate health and well-being across the lifespan.

Items with an * indicate a required field.
Graduate Student Application Form
 
Please check box next to program of interest
Wellness Management  Wellness Management
Applied Gerontology  Applied Gerontology
 
I. PERSONAL INFORMATION
First Name *
Middle Initial *
Last Name *
Address Line 1 *
City *
State *
Zip *
Phone *
Country *
Email *
 
II. ACADEMIC HISTORY
 
A. List all higher education degrees granted and in progress with the most recent listed first
Institution/Degree *
Major/Minor *
Date of or Expected Date of Graduation *    
Institution/Degree
Major/Minor
Date    
Institution/Degree
Beginning Date  
Ending Date  
 
B. Graduate Record Exam Scores (please send photocopy)
Verbal/Quantitative/Analytical *
TOTAL *
 
C. Undergraduate Grade-point Average (please send transcript)
Cumulative GPA *
GPA (last two years of undergraduate work)
 
III. PROFESSIONAL EXPERIENCE List all professional work experience with the most recent listed first (please send resume)
Employer/Job Title
Beginning Date  
Ending Date  
Employer/Job Title
Beginning Date  
Ending Date  
Employer/Job Title
Beginning Date  
Ending Date  
 
IV. PLEASE LIST THE THREE (3) PROFESSIONAL REFERENCES (including complete address and phone) from whom you will be requesting written recommendations supporting your admittance into the program of your choice (wellness management or applied gerontology).
 
Reference # 1
Name *
Agency *
Address *
City, State, Zip *
Business Phone *
 
Reference # 2
Name *
Agency *
Address *
City, State, Zip *
Business Phone *
 
Reference # 3
Name *
Agency *
Address *
City, State, Zip *
Business Phone *
 
V. INTERESTS
 
A. Please write a brief narrative (in the box below), no more than 500 words, of your interest in wellness management or applied gerontology, including personal lifestyle concerns and career goals.
Narrative *
 
B. If you are interested in being considered for a graduate assistantship, please indicate so in a letter of intent (in the box below). Also, please include what qualities and strengths you feel you may bring to the Institute as a graduate assistant.
Letter of Intent