Application for Graduate Admissions Do not fill out this application if you have already completed an online application. Online applications are strongly preferred. Please be advised that paper applications take longer than online applications to process. The Graduate College highly encourages you to apply online. Application for Graduate Admissions This application is to apply for one program for one term. Any changes in program or term requires a new application. Refer to the Change of Session information at www.ohio.edu/graduate Application deadlines are set by each academic program. Please review the program website for details. If no deadline is posted, applications should be submitted at least six weeks prior to the intended start term. For international students who need to apply for a Visa, submit your application at least eight months prior to your intended start term. Applications must be completed and signed by the applicant. Your application cannot be processed without your signature (page 6) and the appropriate application fee. Make check or money order (in US dollar amounts) payable to Ohio University. Do not mail cash. Application fee(s) are NON-REFUNDABLE including applications submitted in error Initial/first Graduate Degree (includes MBA/MSA dual degree) US Citizens/Permanent Residents $50 USD International$55 USD Non-Degree/Certificate, Transient$35 USD Second/Subsequent, Reapplication $25 USD Reapplication to Complete a Degree $25 USD Failure to complete all sections of this form will significantly delay the processing time of your application. False or incomplete information provided as any part of your application material may result in cancellation of the application, admission, and/or registration. Before submitting any application, review the admitting department’s requirements and review your application for accuracy. Use the program code sheet to select your degree code: www.ohio.edu/graduate/programcodes.cfm If you do not find your program code listed, the program does not accept paper applications. You are strongly encouraged to retain a photocopy of your application forms for your own records. Mailing Address: Graduate College Research and Technology Center 220 1 Ohio University Athens, OH 45701-2979 USA Questions? Please e-mail [email protected] or call 1 (740) 593-2800. Degree-Seeking Applicants Mail these documents to the Graduate College: • Complete application • Appropriate application fee • Transcripts from all postsecondary institutions attended, as described in the application information section or the international application section of the Graduate College website. www.ohio.edu/graduate/ apply/domestic.cfm www.ohio.edu/graduate/ apply/international.cfm • Three (3) completed letters of recommendation written on the Ohio University Recommendation Form, in envelopes sealed by the recommender. www.ohio.edu/graduate/upload/ RecommendationForm.pdf • Résumé/CV • Professional Plans* • Personal Statement* • Writing Sample* *Check the application requirements for the program to which you are applying to determine document content, format, and length. International Students Only In addition to the items above, also include: • Copy of passport ID/Photo page and any current Visa documents We recommend using a tracking service for materials being sent from overseas. Application for Graduate Admissions GRADUATE COLLEGE Identification NAME Last/Family name, First/Given and Middle (Example: Smith, John Alexander or Smith, John A.) Please make sure that your name is entered exactly the way it appears on your ID or Passport. PREVIOUS NAME(S) Please list any previous names including maiden name, previous married names, or names you may have used to apply to Ohio University in the past. OHIO Campus ID (begins with P), if any Gender: Male Female P Country of Citizenship: Date of Birth USA Other: MM-DD-YYYY (Example: 01-29-1986) If not a citizen of the USA, are you: Permanent Resident, Alien # Place of Birth Refugee Asylee, File # City, State (Example: Athens, Ohio) Date Approved Is English your native language? Yes No* *If no, you must provide proof of language proficiency. Ethnic Background (US Citizens and Permanent Residents only) This information is optional and will not be used for discriminatory purposes. Are you Hispanic/Latino? Yes No Select one or more races from the following: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Country (if not USA) Social Security Number (SSN) Though you are not required by law to include your SSN on this application, providing your SSN will make it easier to confirm your identity and create your record in Ohio University systems. If you are applying for financial aid, an SSN is necessary to match your Ohio University record to the Free Application for Federal Student Aid (FAFSA). Do you have a U.S. Social Security Number? Yes No Choose not to provide. Administrative use only: Revised October 2014 -- Ohio University Graduate Application, Page 1 of 6 Address & Contact Information Attention Yahoo users: We have determined that Yahoo blocks email from Ohio University, so we strongly encourage you to provide a different email address. If you choose to supply a Yahoo email address, be aware that you may not receive all application correspondence from the Graduate College. EMAIL PHONE (U.S. Home or Cell) Area Code / Number (Example: 740-555-5555) INTERNATIONAL PHONE (including country code) Mailing Address If your mailing address changes prior to an admission decision, please notify the Graduate College. Valid indefinitely Valid until ______________________ Permanent Address Same as Mailing Address International applicants must provide a permanent address outside the United States. Address Line 1 Address Line 1 Address Line 2 Address Line 2 CityState/Province CityState/Province Zip/Postal CodeCountry Zip/Postal CodeCountry Application Information Anticipated Student Status Full-time Part-time If Permanent Residence is in Ohio or Kentucky, please indicate County of Residence To qualify for an exemption to the non-resident tuition surcharge if you are a resident of Ohio or one of the nine (9) Kentucky reciprocity counties, you must complete the Ohio Residency application section. Program Code Use the program code sheet to select your degree code: www.ohio.edu/graduate/programcodes.cfm This application is for: This is my first Ohio University Graduate Degree and I am a US Citizen or permanent resident ($50) Program Name - including dual degree program MBA/MSA Specialization (if any) This is my first Ohio University Graduate Degree and I am NOT a US Citizen or permanent resident ($55) This is NOT my first application for an Ohio University graduate degree. I am (select one) Area of Study (optional) applying for admission to a new or different degree program reapplying for admission to a program I previously applied to but was not admitted reapplying to complete a degree but I have exceeded the time limit I have a waiver code to defer/correct a previous application Planned Term of Enrollment Fall 20 Spring 20 Summer 20 CAMPUS Athens Lancaster/Pickerington Chillicothe Southern Dublin Zanesville Eastern Web-based/Online I am applying for a Non-Degree program or Certificate ($35) Have you previously attended or are you currently attending Ohio University? YES NO Please note: If the answer is yes, the Graduate College will obtain a transcript from Ohio University on your behalf. Revised October 2014 -- Ohio University Graduate Application, Page 2 of 6 Academic History List each college/university you have attended, starting with the institution where you have earned or will earn your bachelor’s degree. Next, list any institution where you have or are currently taking any post-bachelor’s courses or have earned/will earn a post-graduate degree. Finally, list any other college attended where you have taken coursework, even if you did not/will not earn a degree. You must list all previous institutions and provide transcripts, even if courses show as transfer credit on a different transcript. Institution If you have previously attended or are currently attending Ohio University, you must list Ohio University as one of the Colleges/Universities that you have attended. Please note: If English was not the language of instruction for any institution attended, please submit the original language transcript as well as the English translation transcript. COLLEGE / UNIVERSITY ATTENDED Full Name of Institution (no abbreviations) LEVEL OF STUDY = LOCATION City, State & Country (if not U.S.) BEGIN DATE OF ATTENDANCE DEGREE, DIPLOMA, OR CERTIFICATION Example: B.A., B.Sc. Institution Graduate MM-YYYY (Example: 08-2001) END DATE OF ATTENDANCE MM-YYYY (Example: 12-2005) Yes No Did you earn a degree? Yes No Was English the language of instruction? Yes No Have you ever been dismissed or suspended from this institution or one of its programs? Yes No DEGREE AWARDED / EXPECTED MM-YYYY (Example: 05-2006) Behavioral based Academic Graduated No longer have student status Other (Please attach explanation) Are you eligible to return to this institution? COLLEGE / UNIVERSITY ATTENDED Full Name of Institution (no abbreviations) LEVEL OF STUDY = LOCATION City, State & Country (if not U.S.) BEGIN DATE OF ATTENDANCE Undergraduate DEGREE, DIPLOMA, OR CERTIFICATION Example: B.A., B.Sc. Graduate MM-YYYY (Example: 08-2001) END DATE OF ATTENDANCE MM-YYYY (Example: 12-2005) Yes No Did you earn a degree? Yes No Was English the language of instruction? Yes No Have you ever been dismissed or suspended from this institution or one of its programs? Yes Institution Undergraduate No DEGREE AWARDED / EXPECTED MM-YYYY (Example: 05-2006) Behavioral based Academic Graduated No longer have student status Other (Please attach explanation) Are you eligible to return to this institution? COLLEGE / UNIVERSITY ATTENDED Full Name of Institution (no abbreviations) LEVEL OF STUDY = Undergraduate LOCATION City, State & Country (if not U.S.) BEGIN DATE OF ATTENDANCE MM-YYYY (Example: 08-2001) DEGREE, DIPLOMA, OR CERTIFICATION Example: B.A., B.Sc. Graduate END DATE OF ATTENDANCE MM-YYYY (Example: 12-2005) Yes No Did you earn a degree? Yes No Was English the language of instruction? Yes No Have you ever been dismissed or suspended from this institution or one of its programs? Yes No DEGREE AWARDED / EXPECTED MM-YYYY (Example: 05-2006) Behavioral based Academic Graduated No longer have student status Are you eligible to return to this institution? If you hold a valid teaching license, enter the license number: Teaching license state: If you hold a vaild nursing license, enter the license number: Nursing license state: Revised October 2014 -- Ohio University Graduate Application, Page 3 of 6 Other (Please attach explanation) Study Abroad COLLEGE / UNIVERSITY Where you studied abroad LOCATION Full Name of Institution (no abbreviations) BEGIN DATE OF ATTENDANCE mm-yyyy City & Country LEVEL OF STUDY Name of School Sponsoring Study Abroad Program Undergraduate END DATE OF ATTENDANCE mm-yyyy Graduate If you completed high school or secondary school outside of the US, provide the school location and completion certificate type: SECONDARY SCHOOL COUNTRY COMPLETION / LEAVING CERTIFICATE TYPE For a transcript to be considered official, it must be in an envelope sealed by the issuing institution, have the institution’s seal and/or watermark, and have the registrar’s official signature. All transcripts must also include your name, the name of the school, and dates of attendance. For examples of what is acceptable as a transcript click on the following applicable links: Domestic: www.ohio.edu/graduate/apply/domestic.cfm DATE RECEIVED mm-yyyy If you graduated from an Ohio high school, complete the Eligibility for In-State and Kentucky Reciprocity Tuition Rates form attached to the end of this application. Test Information Indicate which tests you have taken or will take. You can include photocopies of student test reports with your application materials, but only scores received directly from the testing agency are accepted as official. The Ohio University institution code is #1593. Department codes are not required. GMAT Date: mm-yyyy GRE Date: International: www.ohio.edu/graduate/apply/international.cfm For a test score to be considered official, it must be sent directly from the testing agency to the Graduate College. Please check the department/program website or contact the academic program to which you are applying for any supplemental material requirements. These may include: • Résumé or CV • Statement of Professional Plans/Goals • Personal Statement, autobiographical sketch, and/or statement of intent • School-issued English proficiency documents • Writing sample(s) mm-yyyy GRE Subject Test Date: mm-yyyy Test name IELTS Date: mm-yyyy TOEFL Date: mm-yyyy Other test name Date: mm-yyyy I am applying for English Provisional Admission to study English in advance of joining the degree program. (refer to application instructions for description) Required Information An affirmative answer on any of the following questions does not necessarily bar admission, but does require review. Attach a separate page explaining any affirmative answer. Failure to do so will significantly delay processing of your application. Yes No Are you now or have you ever been charged with or under indictment for a felony? Yes No Are you now or have you ever been charged with or indicted for an act you committed as a child that would be a felony if committed by an adult? Yes No If the answer to either or both of the immediately preceding questions is yes, were you convicted of a felony and/or were you adjudicated as a delinquent child for an act that would be a felony if committed by an adult? At all times, as an applicant or a student, you are required to notify Ohio University’s Office of Legal Affairs of any charge, indictment or conviction involving a felony or act that would be a felony if committed by an adult. Failure to provide such notification may result in student disciplinary action, up to and including expulsion from Ohio University. Revised October 2014 -- Ohio University Graduate Application, Page 4 of 6 Funding Opportunities Yes No Do you wish to be considered for departmental funding? Contact the department or school for further information on types of available assistantships. Department funding is available only to students in Athens-based programs. If yes, select all that are of interest to you Graduate Assistantship Letters of Recommendation List three people who are submitting a recommendation on your behalf. See the application instructions for information about obtaining recommendations. 1) 2) Research Assistantship Teaching Assistantship If English is not your native language,please include a personal summary statement describing your previous work and educational experience in an English language environment. Yes No Do you plan to apply for federal student loans? Yes No Do you anticipate funding through a scholarship agency or educational agency? Agency name: 3) Potential Academic Advisors Some academic departments request that applicants list up to three potential advisors. Please review the admitting department’s application requirements and determine if you should provide the information in the spaces below. 1) 2) Yes No Do you qualify for US Military Educational Benefits? Yes No Are you eligible for the Ohio University Employee Tuition Benefit? Full-time Presidential Contract employees are subject to Conflict of Interest, Faculty Handbook Policy IV-F. If yes, are you a full-time employee of Ohio University? Administrative Faculty Classified/Bargaining Unit Ohio University Employee classification: Position Title Department Campus Address 3) International Students Only Please include either a photocopy of your passport identification page or a photocopy of your birth certificate (in English) with your application. Do you currently hold a U.S. non-resident visa? If yes, specify type: B J-2 F-1 H-1 F-2 H-4 J-1 Other Yes No If you are currently in the U.S. on a visa, provide a photocopy of your form I-94 with this application. Supervisor Name If you are currently an F-1 or J-1 visa holder, also include a photocopy of your I-20 or DS-2019. It is the policy of Ohio University that there shall be no discrimination against any individual in educational or employment opportunities because of race, religion, color, sex, sexual orientation, national origin, ancestry, age, gender identity or expression, mental or physical disability, or veteran status. Ohio University is an affirmative action institution. The following person has been designated to handle inquiries regarding the nondiscrimination policies: Special Assistant to the Executive Vice President and Provost, Office for Institutional Equity, Ohio University, Athens, Ohio 45701, Telephone 740.593.2620. If you have a pending request for U.S. Permanent Residency or Asylum, indicate your current or most recent visa type: F-1 H J-1 category Other International Student Financial Support Form Please access the The Ohio University Graduate College Financial Support Form for International Students and instructions for completing the form at: www.ohio.edu/graduate/international/upload/FinancialSupport-Form2.pdf Revised October 2014 -- Ohio University Graduate Application, Page 5 of 6 Authorized Persons If you have a friend or relative who will be contacting the Graduate College regarding your file, please list their name below. I authorize the following persons to receive information regarding my application and/or visa papers. NAME Last/Family name, First/Given and Middle (Example: Smith, John Alexander or Smith, John A.) Signature Your signature is required to process the application. I certify that the information given in this application is complete and accurate. I understand that furnishing false or incomplete information as any part of this application material may result in cancellation of admission, registration, or both. I understand that credentials supplied to support my admissions application become the property of Ohio University and cannot be returned to me. I further understand that I am responsible for providing all academic credentials even if I have previously applied to or been a student of Ohio University. I authorize Ohio University to contact previous schools attended to obtain or verify information in connection with this application. I also authorize Graduate College to update my address to reflect the information in this application. Signature Date Revised October 2014 -- Ohio University Graduate Application, Page 6 of 6 Eligibility for In-State and Kentucky Reciprocity Tuition Rates You must complete and submit this form with your application if you believe you qualify for in-state tuition rates as a resident of Ohio, a dependent of residents of Ohio, or a resident of a qualifying Kentucky reciprocity county. Be sure that any supporting documents include your full name, birth date and Ohio University PID number, if available. The residency policy is found in the Graduate Catalog on-line at www.ohio.edu/graduate/catalog. NAME Last/Family name, First/Given and Middle (Example: Smith, John Alexander or Smith, John A.) How long have you lived in Ohio or Kentucky years / months years / months List all addresses where you have resided in the past 12 months (attach additional page if necessary) Current address from mm-yyyy number & street to city Employed: county Full Time Part Time state In School: zip code Full Time Part Time mm-yyyy Previous address from mm-yyyy number & street to city Employed: county Full Time Part Time state In School: zip code Full Time Part Time mm-yyyy Previous address from mm-yyyy number & street to city Employed: county Full Time Part Time state In School: zip code Full Time mm-yyyy Yes No Do you have a driver’s license or state ID card? If yes, issued by which state? Yes No Are you registered to vote? If yes, in which state? Yes No Do you operate a motor vehicle? If yes, registered in which state? Yes No Do you have a checking or savings account? If yes, in which state(s)? Yes No Did you file a state or federal tax return or pay income taxes in the past 12 months? If yes, in which state(s)? Revised October 2014 -- Eligibility for In-State and Kentucky Reciprocity Tuition Rates Form, Page 1 of 2 Part Time Check all that apply: I graduated from an Ohio high school. School Name You must submit an official high school transcript to the Graduate College to qualify for resident status under the “Forever Buckeye” program City I receive more than 50% of my support from parents, spouse, legal guardian, or other. Dates that person(s) has lived in Ohio: Never From birth to present From to Dates that person(s) has lived in Kentucky Never From birth to present From to I am currently employed in Ohio or Kentucky in a full or part-time, self-sustaining position. Employer City / State Date of Hire I am currently enrolled in a college or university: School name State If this is a public institution, are you paying in-state tuition rates? Yes No I was claimed as a dependent on a tax return in the most recent tax year. State of residence of person who claimed me: I am in the U.S. military on active duty, my home of record is Ohio, my income taxes are filed with/paid to the State of Ohio, or I am a dependent of such person. Attach documentation I will be on active military duty stationed and residing in Ohio while a graduate student or I am a dependent of such person. Include copy of military duty orders with application or forward to the Graduate College when issued According to U.S. Citizenship and Immigration Services, I am a Permanent Resident Alien or other legal alien granted indefinite stay. Attach documentation I currently hold a non-immigrant visa and I am the dependent of an Ohio or Kentucky Resident. Requires residency petition for classification as an Ohio resident. I am currently in VISTA, AmeriCorps, City Year, the Peace Corps, or similar program. Include a letter from the program to verify participation Program name I certify that the information I have provided in this application for in-state tuition rates is complete and accurate. I understand that furnishing incomplete or incorrect information as any part of this application material may cause me to be billed nonresident fees. Signature Date Revised October 2014 -- Eligibility for In-State and Kentucky Reciprocity Tuition Rates Form, Page 2 of 2
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