Application for Graduate Admissions Do not fill out this application

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