COLUMBUS STATE UNIVERSITY International Graduate Application APPLICATION PROCEDURES International applicants applying to CSU for Graduate studies must submit the following: 1. Submit this Application for Admission form, accompanied by a $50 non-refundable application fee. Previously enrolled students do not pay the application fee. 2. Applicants seeking admission to a Master’s program must provide a course by course professional transcript evaluation with GPA calculation by a NACES evaluator or Lisano International from any non-U.S. accredited college or university. We recommend WES or Josef Silny & Associates, Inc. 3. All applicants requesting admission to a graduate program are required to submit official test scores on an entrance examination appropriate to the degree objective. Applicants for a Master of Education degree, a Master of Science degree, a Master of Public Administration degree, and a Specialist in Education degree must submit scores of the Graduate Record Examination (GRE). Applicants for a Master of Business Administration degree must submit scores of the Graduate Management Admission Test (GMAT). Requests for GMAT and GRE scores may be sent to ETS at the following addresses: Graduate Management Admissions Test Graduate Record Examination ETS, Box 966, Princeton, NJ 08540 ETS, Box 966, Princeton, NJ 08540 Applicants who wish to take any of these examinations on the CSU campus should contact the Testing Center at (706) 568-2226. GRE and GMAT scores from tests taken more than five years prior to application for admission will not be accepted. Applicants whose native language is not English must provide evidence of English language proficency by meeting minimum score requirements of either: TOEFL, IELTS, or MTELP. Applicants who earn an undergraduate degree from a regionally accredited U.S. college or university are not required to provide proof of English language proficiency. 5. Applicant must submit a completed Certificate of Immunization. Forms are available online at: http://admissions.columbusstate.edu/forms/index.php 6. A financial guarantee form must be supplemented with an original bank certificate if the applicant is self supporting. If being financially supported by a sponsor an original bank certificate and letter of support are required. 7. Data such as ethnic origin, sex, and handicap are used for statistical reporting and will not be used in any way for rendering admission decision. 8. Action will not be taken on the application until all the credentials listed above have been received. 9. International applicants are to meet the following deadlines (all the necessary documents need to be submitted by the appropriate date): Fall semester Spring semester Summer semester – – – June 1st November 1st April 1st International Graduate Admission Application n Please print all information and check the appropriate boxes. A one-time $50 application fee is required n All information on application should match passport n Office of Admissions n Columbus StateUniversity 4225 University Avenue n Columbus, GA 31907-5645 n (706) 507-8800 Toll Free 1-8666-264-2035 (For applicants who are neither U.S. citizens or U.S. permanent residents) If you are a U.S. citizen or have permanent resident status, please contact the CSU Admissions Office for a U.S. student application packet. APPLICANT INFORMATION _______________________ Name ___________________________________________________________________________________________________________ U.S.Social Security Number Last (Family name) First (Given name) Middle Jr. (If available) Place of Birth) ______________________________________________________________________Country of Citizenship ________________________________ City Country Permanent Address ___________________________________________________________________________________________________________________________ Number and Street Work Telephone Home Telephone (Country Code, City Code, Numbers) ___________________________________________________________________________________________________________________________ City State Zip + 4 Country Mailing Address ___________________________________________________________________________________________________________________________ (or check if same as above) o Number and Street Telephone (Country Code, City Code, Numbers) ___________________________________________________________________________________________________________________________ City State Zip + 4 Country Former/Maiden Name (if applicable) ___________________________________________________________________________________________________________ Last First E-mail Address ______________________________________________________________________________________ Date of Birth (Month, day, year) ______________ Sex (M) o Male (F) o Female Native Language o English o Other _______________________ Specify Race / Ethnic Information Are you Hispanic or Latino? Yes What is your race? (Choose one or more) q White q Black or African-American q Asian No q American Indian or Alaska Native q Native Hawaiian or other Pacific Islander Are you currently in the United States? oYes. What is your current immigration status? ________________________________________ oNo. Are you planning to apply for F-1 student visa? ____________________________ (Please list current institution) ________________________________________________________________________________________________________________ ADMISSIONS INFORMATION Year and Semester You Plan To Enter: o Fall o Spring o Summer 20 _____ Classification: o Degree Seeking o Transient Examinations: o Graduate Management Admission Test (GMAT) o Graduate Record Exam (GRE) o MAT REV 2.12 Index Code: GINTL All Previous Educational Experience (Include prior attendance at CSU.) Dates of Attendance From To Location City, State Institution Graduation Date Major Degree Obtained Last College ______________________________________________________________________________________________________________________________ College __________________________________________________________________________________________________________________________________ College __________________________________________________________________________________________________________________________________ College __________________________________________________________________________________________________________________________________ College __________________________________________________________________________________________________________________________________ INTENDED PROGRAM OF STUDY Please check intended Master’s Program __ Master of Business Administration (MBA) __ Master of Public Administration (MPA) __ Government Administration __ Health Services Administration __ Justice Administration __ Justice Administration (Command College) __ Master of Science (MS) in: __ Applied Computer Science __ Software Development __ Information Assurance __ Modeling and Simulation __ Applied Computer Science (On-line) __ Software Development __ Information Assurance __ Modeling and Simulation __ Community Counseling __ Environmental Science __ Instructional Technology __ Organizational Leadership __ Human Resources __ Servant Leadership Do you hold a valid teaching certificate? Type (level) of certificate __ Master of Music (MM) in: __ Master of Arts in Teaching (MAT) __ Artist Diploma (Certificate) __ Music Education Concentration: Conducting (Choral and Instrumental) __ Music Performance __ General Music __ Pedagogy __ Master of Education (MEd) in: __ Art Education __ Early Childhood Education __ Educational Leadership __ Health and Physical Education __ Middle Grades Education __ School Counseling __ School Library Media __ Secondary English Lang. Arts __ Secondary Mathematics Education __ Secondary Science Education __ Secondary Social Science Education __ Special Education General Curriculum o Yes __ Early Childhood Education __ Health and Physical Education __ Middle Grades Education __ School Library Media __ Secondary English Education __ Secondary Mathematics Education __ Secondary Biology Education __ Secondary Chemistry Education __ Secondary Earth Science Education __ Secondary History Education __ Special Education -General Curriculum __ Art o No If yes, what state? ____________________________________________________ ________________________________ Area (field) of certification ________________________________________________ Please check intended Specialist in Education Program (EdS) __ Early Childhood Education __ Educational Leadership __ Middle Grades Education __ School Counseling __Secondary Education in English Language Arts __ Secondary Education in Social Science __ Secondary Education in Mathematics __Secondary Education in Science Doctoral Program (EdS) __ Ed.D. in Curriculum and Leadership ADDITIONAL INFORMATION 1. 2. Have you ever applied to CSU as an undergraduate or graduate student? o Yes o No If yes, date ___________ , ________ Have you ever been enrolled at CSU as an undergraduate or graduate student? o Yes o No 3. Are you currently enrolled in the last institution attended? o Yes o No If yes, request final transcript be sent to CSU Office of Admissions. 4. Have you ever been convicted of any criminal offense other than a traffic violation or do you have charges pending? 5. Telephone number where you can be reached during the day _____________________ 6. State briefly why you want to attend CSU _____________________________________________________________________________ 7. If you will need any special services while on campus because of a disability, please contact our Office of Disability Services at 706-568-2330. 8. Will you need campus housing? _______________________ All applications and documents required must be received in the Admissions Office by the published deadline date. CERTIFICATION I understand that any material false statement made knowingly and willfully by me on this application, or any documents attached hereto may, in accordance with O.C.G.A. 16-10-71, which provides that upon conviction, a person who knowingly commits the offense of false swearing shall be punished by a fine of not more than $1,000 or by imprisonment for not less than one nor more than five years, or both, subject me to prosecution in a court of law. Additionally, I further understand than any such false statement may subject me to immediate dismissal from the institution. Further, I certify that, to the best of my knowledge, the information submitted on this application is true and complete. Signature _____________________________________________ Date _____________________ REV 2.12 Index Code: GINTL
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