<% dim errors errors = "" sent = false if request("action") = "send" then firstName = trim(request.form("firstName")) middleName = trim(request.form("middleName")) lastName = trim(request.form("lastName")) ssn = trim(Request.Form("ssn")) street = trim(request.form("street")) city = trim(request.form("city")) state = trim(request.form("state")) zip = trim(request.form("zip")) countryofb = trim(request.form("countryofb")) phoneHome = trim(request.form("phoneHome")) email = trim(request.form("email")) cemail = trim(Request.Form("cemail")) semester=trim(Request.Form("semester")) gender = trim(request.form("gender")) birthdayA = trim(request.form("birthdayA")) birthdayB = trim(request.form("birthdayB")) birthdayC = trim(request.form("birthdayC")) birthday = birthdayA & "/" & birthdayB & "/" & birthdayC errors = CheckInput() if len(errors) = 0 then set rst = Server.CreateObject("adodb.recordset") sql = "select * from Options" rst.open sql, conn, 1, 2 'if not rst.eof then ' ToAdmissionRequest = rst("ToAdmissionRequest") 'else ' ToAdmissionRequest = "info@texastcm.edu" 'end if rst.close Set myEmail = Server.CreateObject("CDO.Message") schemasURL = " http://schemas.microsoft.com/cdo/configuration/" With myEmail.Configuration.Fields .Item(schemasURL & "sendusing") = 2 .Item(schemasURL & "smtpserver") = "localhost" .Item(schemasURL & "smtpconnectiontimeout") = 10 .Item(schemasURL & "smtpserverport") = 25 .Item (schemasURL & "smtpusessl") = False .Item (schemasURL & "smtpconnectiontimeout") = 60 .Update End With myEmail.From = firstName & " " & lastName & " <" & email & ">" myEmail.To = "info@texastcm.edu" myEmail.CC = "admissions@texastcm.edu" myEmail.Subject = "www.texastcm.edu Online registration from " & firstName & " " & lastName myEmail.TextBody = now & vbcrlf &_ "The following information has been submitted through Online Application Form" & vbcrlf &_ "http://www.texastcm.edu" & Request.ServerVariables("URL") & vbcrlf & vbcrlf &_ "Apply for which semester: " & semester & vbcrlf &_ "First Name: " & firstName & vbcrlf &_ "Middle Name: " & middleName & vbcrlf &_ "Last Name: " & lastName & vbcrlf &_ "SSN: " & ssn & vbcrlf &_ "Street: " & street & vbcrlf &_ "City: " & city & vbcrlf &_ "State / Province: " & state & vbcrlf &_ "Zip / Postal Code: " & zip & vbcrlf &_ "Home Phone: " & phoneHome & vbcrlf &_ "Work Phone: " & Request.form("workHome") & vbcrlf &_ "Email: " & email & vbcrlf &_ "Date of Birth: " & birthday & vbcrlf &_ "Gender: " & gender & vbcrlf &_ "Are you a US Citizen: " & Request.form("uscitizen") & vbcrlf &_ "If NO list VISA or recidency status: " & Request.form("visa") & vbcrlf &_ "Country of Birth: " & countryofb & vbcrlf &_ "If foreign student applicant, are you applying for student VISA? " & Request.form("applyvisa") & vbcrlf &_ "If your native language is not English, note TOEFL score: " & Request.form("tscore") & vbcrlf &_ "Date taken: " & Request.form("tdate") & vbcrlf &_ "Driver's License Number: " & Request.form("driverl") & vbcrlf &_ "State: " & dlstate & "Expired date: " & Request.form("dlexpire") & vbcrlf &_ "Name, address and telephone number of a person through whom you can always be reached:" & vbcrlf &_ "Name: " & Request.form("rname") & vbcrlf &_ "Address: " & Request.form("raddress") & vbcrlf &_ "City: " & Request.form("rcity") & " State: " & Request.form("rstate") & " Zip: " & Request.form("rzip") & vbcrlf &_ "Home Tel: " & Request.form("rhomephone") & " Work: " & Request.form("rworkphone") & vbcrlf &_ vbcrlf &_ "International Students" & vbcrlf &_ "1. Accurate estimate of available personal funds -- monthly amount: $" & Request.form("personalfund") & vbcrlf &_ "2. Accurate estimate of funds from parents/family -- monthly amount: $" & Request.form("familyfund") & vbcrlf &_ "3. Other source of support(specify): " & Request.form("othersupport") & " monthly amount: $" & Request.form("otherfund") & vbcrlf &_ "Estimate of Total monthly support: $" & Request.form("tmonthsupport") & " Total Annual Support: $" & Request.form("tannualsupport") & vbcrlf &_ vbcrlf &_ "Education" & vbcrlf &_ " School or College City and State Date attended Degree(s) and Major" & vbcrlf &_ "School 1: " & Request.form("college1") & vbcrlf &_ "School 2: " & Request.form("college2") & vbcrlf &_ "School 3: " & Request.form("college3") & vbcrlf &_ "School 4: " & Request.form("college4") & vbcrlf &_ "List any special honors/recognition received:" & vbcrlf &_ Request.form("specialhonor") & vbcrlf &_ vbcrlf &_ "Work and Professional experience:" & vbcrlf &_ " Dates Job title Name of Organization and location Nature of work" & vbcrlf &_ "Job 1: " & Request.form("work1") & vbcrlf &_ "Job 2: " & Request.form("work2") & vbcrlf &_ "Job 3: " & Request.form("work3") & vbcrlf &_ "Job 4: " & Request.form("work4") & vbcrlf &_ "Have you ever had a professional license revoked or suspended: " & Request.form("license") & vbcrlf &_ "If yes, please explain the circumstances: " & vbcrlf &_ Request.form("circumstances") & vbcrlf &_ "How did you learn about TCTCM: " & Request.form("learntctcm") & vbcrlf &_ vbcrlf &_ "Financial Data" & vbcrlf &_ "1. How will you pay tuition? " & Request.form("paymethod") & vbcrlf &_ "2. Do you plan to apply for Stafford Loans or other benefits? " & Request.form("sloan") & vbcrlf &_ "3. Have you ever defaulted on a sutdent loan or declared bankruptcy ?" & Request.form("stloan") & vbcrlf &_ "If yes, Please explain fully:" & vbcrlf &_ Request.form("stexplain") & vbcrlf &_ vbcrlf &_ "References" & vbcrlf &_ " Name Position Address Telephone Number" & vbcrlf &_ "person 1: " & Request.form("reference1") & vbcrlf &_ "person 2: " & Request.form("reference2") & vbcrlf &_ "person 3: " & Request.form("reference3") myEmail.Send Set myEmail = Nothing sent = true end if else firstName = "" middleName = "" lastName = "" ssn="" street = "" city = "" state = "" zip = "" country = "" phoneHome = "" workphone = "" email = "" cemail = "" gender = "" birthdayA = "" birthdayB = "" birthdayC = "" placeOfBirth = "" citizenship = "" DL = "" end if %>

Online Registration

Master of Acupuncture and Oriental Medicine


<% if sent = true then %> Thank You for your interest.  We will contact you shortly. <% else %> <% if len(errors) > 0 then response.write("" & errors & "") end if %>
  2008 Spring
Semester 		  2008 Summer
Semester 		  2008 Fall
Semester 		  2009 Spring
Semester 		  2009 Summer
Semester 		  2009 Fall
Semester
Applicant Data:
First Name:
 * Middle Name:   Last Name: *
SSN: *
Street Address: *
City: * State / Province: * Zip / Postal Code: *
Home Phone: * Work Phone:     
Email: * Confirm Email: *
Date of Birth: * / / (MM/DD/YYYY) Gender: *
Are you a US Citizen? Yes No If "NO" List VISA or residency status:
Country of Birth: * If foreign student applicant, are you applying for student VISA?:
If your native language is not English, note "TOEFL" score: date taken:
Driver's License Number: State: Expires:
Name, address & telephone number of a person through whom you can always be reached:
Name: Address:
City: State: Zip:
Home Phone: Work Phone:
INTERNATIONAL STUDENTS (This information is required from foreign students) Statement of Financial Support: The annual estimated cost of attending TCTCM for tuition and living expenses is approximately $ 22,000.00 U.S. laws require you to establish your means of support while attending school. Please list your sources of support and include "documentary evidence" and sponsor's letters of support with this application.
1. Accurate estimate of available personal funds: Monthly amount $
2. Accurate estimate of funds from parents/family Monthly amount $
3. Other sources of support (specify): Monthly amount $
Estimate of Total Monthly support $ Total Annual Support $
EDUCATION (List all colleges & post-secondary schools attended, without exception):
Schoole or College City and State Dates attendated Degree(s) & Major
List 1:
List 2:
List 3:
List 4:
List any special honors/recognition received:
WORK & PROFESSIONAL EXPERIENCE (beginning with most recent)
Date Job Title Name of Organization & Location Nature of Work
List 1:
List 2:
List 3:
List 4:
Have you ever had a professional license revoked or suspended? Yes No
If yes, please explain the circumstances:
How did you learn about TCTCM?
FINANCIAL DATA
1. How will you pay tuition? Savings Employment Loan Other
2. Do you plan to apply for Stafford Loans or other benefits? Yes No
If yes, please call our Financial Aid Officer for assistance, as soon as possible.
3. Have you ever defaulted on a student loan or declared bankruptcy? Yes No
If yes, please explain fully:
(TCTCM reserves the right to conduct a credit check, if there is "just cause" to do so)
REFERENCES (Identify three persons who knowledgeable of your skills and ability):
Name Position Address Telephone Number
List 1:
List 2:
List 3:
APPLICATION CHECKLIST (Application must be complete & the following submitted):
1. Non-refundable application fee of $75.00 for resident students and foreign students who reside in the U.S., payable to the Texas College of Traditional Chinese Medicine. Application fee for foreign students who reside outside the U.S. is $300.00 and an evaluation fee of $200.00 for overseas documents (transcripts, credentials, ets.)
2. Complete and official transcripts mailed in a sealed envelope directly from the institution where the work was completed. Foreign students must provide an English translation of official documents.
3. Two (2) face photographs of passport quality and size.
4. A letter of interest explaining your reasons for wanting to attend the master¡¦s degree program at Texas College of TCM.
5. Photocopy of Driver's License.

Also, you can print out the Admission Application Form and mail or fax it to us.


<% end if %><% '############################### function CheckInput() dim errors errors = "" if firstName = "" then errors = errors & "First Name is required.
" elseif len(firstName) > 50 then errors = errors & "First Name must not exceed 50 characters.
" end if if lastName = "" then errors = errors & "Last Name is required.
" elseif len(lastName) > 50 then errors = errors & "Last Name must not exceed 50 characters.
" end if if ssn = "" then errors = errors & "SSN is required.
" elseif len(ssn) > 9 then errors = errors & "SSN must not exceed 9 digits.
" end if if street = "" then errors = errors & "Street Address is required.
" elseif len(street) > 50 then errors = errors & "Street Address must not exceed 50 characters.
" end if if city = "" then errors = errors & "City is required.
" elseif len(city) > 50 then errors = errors & "City must not exceed 50 characters.
" end if if state = "" then errors = errors & "State / Province is required.
" elseif len(state) > 50 then errors = errors & "State / Province must not exceed 50 characters.
" end if if zip = "" then errors = errors & "Zip / Postal Code is required.
" elseif len(zip) > 10 then errors = errors & "Zip / Postal Code must not exceed 10 characters.
" end if if phoneHome = "" then errors = errors & "Home Phone is required.
" elseif len(phoneHome) > 20 then errors = errors & "Home Phone must not exceed 20 characters.
" end if if email = "" then errors = errors & "Email is required.
" elseif len(email) > 50 then errors = errors & "Email must not exceed 50 characters.
" end if if cemail = "" then errors = errors & "Confirm email is required.
" elseif len(cemail) > 50 then errors = errors & "Email must not exceed 50 characters.
" elseif email<>cemail then errors = errors & "Comfirm email does not match previous.
" end if if gender <> "Male" and gender <> "Female" then errors = errors & "Gender must be either Male or Female.
" end if if len(birthday) < 3 then errors = errors & "Birthday is required.
" elseif isDate(birthday) = false then errors = errors & "Birthday " & birthday & " does not appear to be valid.
" else currentDate = date() currentYear = year(currentDate) ' less than 12 or more than 100 years old??? if currentYear - birthdayC < 12 or currentYear - birthdayC > 100 then errors = errors & "Birthday " & birthday & " does not appear to be valid.
" end if end if CheckInput = errors end function %>