Application for Graduate Admission

*Required Information

You will receive an email confirming your submission of this application. Please notify the Office of Enrollment Services if you do not receive an email within 24 business hours of your submission.

BIOGRAPHICAL INFORMATION

Last Name*:         First Name*:      Middle Name:

Other Names on Transcripts:

Social Security Number:   Date of Birth*:  

Demographic Information
This optional information requested in this section of the application for graduate admission is voluntary and will not be used in a discriminatory manner.

Gender:             Ethnic Background:African-American      Asian                Caucasian         Hispanic           Native American  Other:
                                                                                                     

Home Phone:         Work Phone:  

Cell Phone:   

Personal Email*:
   Work Email:

Present Mailing Address*:                                          Permanent Mailing Address*:
(No., street, apt. city, state, zip country)               (No., street, apt. city, state, zip country)
        

Are you a veteran of U.S. Armed Forces?     Yes    No
Have you ever been convicted of a felony?* Yes   No
If yes, please send a written explanation or copy of adjudication.

Citizenship Status*:
U.S. National:(includes U.S. citizens,                   Non-Resident Alien:
     permanent residents possessing Alien                 Visa Type & No:
     Registration Receipt Card I-151 or 551                
     those with Temporary Resident Card I-688,
     and refugees)
   

INTERNATIONAL APPLICANTS ONLY

Country of Citizenship:           Country of Birth:                        City of Birth:
          
Will you require a student visa?  Yes No 
      
Current or Requested VISA                                              (If you are a J1/J2 visa holder, send a copy of your IAP-66 to the 
F1  F2 J1  J2  Other                      Graduate Records Office.)
Do you have n Immigrant Registration Number? Yes No
If Yes, give the number:

APPLICATION DATA

Term you wish to enroll*:   What Graduate status are you seeking*?          
     
Graduate Program to which you are making application*:

Have you previously applied for admission to this university?* Yes  No
(degree, non-degree, unclassified, or undergraduate)

Did you register?  Yes No   If yes, Semester:
  Year:

Graduate Course Delivery*:  

How did you hear about the Graduate Program at University of the Southwest?   

Have you ever been suspended or dismissed from, or encouraged to leave any college or university or advanced program?
No                 Yes              If yes, please explain in detail:

EDUCATIONAL BACKGROUND
List ALL previous colleges and universities attended, including University of the Southwest. List most recent first.

Name of College or University and Location*

From mo./yr.*

To: mo./yr.*  

Major Field of Study*

Actual Name of Degree or Diploma *
(Do not translate)
  

Date Received or Expected*

  

 

 

 

 

 

Emergency Contact Person*:
Relationship*:   Phone*:

By clicking Submit, I certify that the information provided on this application and all required documents are true and accurate to the best of my knowledge and understand that omissions or falsifications may result in withdrawal of a decision to accept me. I further understand that I must request and provide official transcripts from all previous colleges or universities attended before I may be admitted to a graduate program.



The University makes available to students of any race, color or national or ethnic origin all the rights, privileges, programs, and activities generally accorded or made available to students. It does not discriminate on the basis of sex, marital or parental status, race, color, religion, age, or national or ethnic origin in the administration of its educational policies, admission policies, financial aid programs, or other University-administered programs.