Graduate Application
Graduate Application
□ U.S. Citizen □ Permanent Resident (copy of Resident Alien Card must accompany application) □ Other (specify VISA type) ___________
Pennsylvania Resident # Yes # No If yes, how long (yrs) __________ If no, State or Country where you reside___________________________
Have you previously applied for graduate admission to IUP? □ Yes □ No If yes, when? ____________________________________________
Were you ever convicted of a felony? □ Yes □ No (If yes, additional information will be sent to you).
This information is voluntary. It is intended for statistical purposes only and will not be used as a factor in determining your admission to the
university.
□ American Indian/Alaskan Native □ Black or African-American Non-Hispanic □ White Non-Hispanic
□ Asian/Pacific Islander □ Hispanic or Latino □ Other___________________________
Gender □ Male □ Female Birth Date: ________/_________/_________
Employment History:
Fellowships, Scholarships, Academic Honors Received – List and Give Dates: ________________________________________________________
_______________________________________________________________________________________________________________________
List in chronological order all colleges/universities attended. An official transcript of each is required.
College/University Country/State From Mo./Yr To Mo./Yr Major Degree and Date
Program of Interest: List code (Please refer to the program code, applications deadlines, information located on the back of this application):
#Program Name: ______________________________________________________
Location: □ Indiana □ Harrisburg □ Monroeville □ Northpointe (Check the Program Codes for Location)
Other_____________________________________
Intended Enrollment – Term: □ Spring □ Summer □ Fall Year 20____ □ Full-time □ Part-time
I understand that any misrepresentation of facts on this application will be cause for refusal or cancellation of my admission to the School of Graduate
Studies and Research at Indiana University of Pennsylvania.