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GRADUATE OFFICE
STATE UNIVERSITY OF NEW YORK AT OSWEGO
ROOM 602 CULKIN HALL OSWEGO, NEW YORK 13126
APPLICATION FOR ADMISSION TO GRADUATE STUDY - MASTER'S OR CERTIFICATE OF ADVANCED STUDY PROGRAM
Admission to graduate program status is limited to those whose formal graduate degree or CAS applications and credentials undergo the examination and review evaluation of the appropriate department admission committee. Final approval for admission and notification to the applicant is made by the Graduate Office. Satisfactory completion of course work as a non-degree graduate student should not be construed as informal approval for admission to a degree program.
Applying for: __Full-time study __Part-time study Semester applied for: __Fall __Spring __Summer Year____________
Name (Given, Family)______________________________________________ Gender: M_____F_____
Date of Birth_______________Country of Birth___________________Place of Birth___________________
Are your educational records filed under a different name? __No ___Yes If yes, what name:________________________
Social Security Number*_________________Phone: Area Code __(____)______________ Work Phone_______________
* Disclosure of Social Security numbers is voluntary and is used to facilitate identification and record keeping. Authority to solicit the Social Security number has been established under Section 355 of the Education Law of the State of New York.*
Current Mailing Address ______________________________________________________________________________
(STREET-- CITY-- STATE-- ZIP)
Predominant Ethnic Background (See codes below)_____________
8) White; 6) Hispanic; 3) Asian (including India) or Pacific Islander; 2) Black Non-Hispanic;1) American Indian or Alaskan Eskimo
Permanent Mailing Address _________________________________________________________________________
(STREET-- CITY-- STATE-- ZIP)
E-Mail Address____________________________________Phone: Area Code (_____) _________________________
Citizenship: ___________United States New York State Resident? ____Yes ____No
Other:_______________________ Visa type_________________________________
DESIRED AREA OF GRADUATE STUDY
Graduate Program Code Number______________________ Please refer to the back of the application checklist and enter the program to which you are applying. If you are applying to the MSEd program, please indicate the specialty strand number involved.
TEACHING CERTIFICATION
Now qualified to teach_________________________________________________ by the following certificate:
Type__________________________ State_______ Number_______________ Date of Issuance____________
SUMMARY OF COLLEGE OR GRADUATE SCHOOL PREPARATION
List colleges or universities attended or where work is in progress, giving dates of attendance, degrees awarded or anticipated with dates for these degrees. List most recent attendance first. One official transcript from each institution must be submitted with your application. (SUNY Oswego graduates are exempt from submitting a transcript.)
INSTITUTION MAJOR DATE ENTERING DATE LEAVING DEGREE AND DATE
1.______________________ ________________ _______________ __________________ ___________________
2.______________________ ________________ _______________ ___________________ __________________
3.______________________ ________________ _______________ ___________________ __________________
4.________________________ ______________ _______________ ___________________ __________________
Honors, prizes, scholarships, honor societies, professional associations and offices held:
_________________________________________________________________________________________
Foreign language proficiency: Do you read or write a foreign language other than English?_____
If so, identify the language _______________________________________
Have you enrolled previously as a non-degree graduate student at Oswego? ___No __Yes Last semester attended_________ If yes, please show number of hours accumulated: _____________________
SUMMARY OF PROFESSIONAL EXPERIENCE
Indicate all professional positions held: (List present employment first)
EMPLOYER ADDRESS DATES POSITIONS HELD
1. _____________________ ________________________ __________________ ______________________________
2. _____________________ ________________________ __________________ ______________________________
3. _____________________ __________________________ __________________ _____________________________
4. _____________________ __________________________ __________________ _____________________________
GRE or GMAT scores must be within five years of the date of admission review to remain valid for use. When did you, or when do you plan to, take the Examination(s), if required?
GRE Verbal:__________ Quantitative_________ Analytical _____ Exam Date:________
GMAT Score:______________ Exam Date:___________ TOEFL Score:_______________ Exam Date:__________
List below the names of referees whom you have asked to write letters of recommendation to support your application.
1._______________________________________________________________________________________________
2._______________________________________________________________________________________________
3._______________________________________________________________________________________________
Are your applying for financial aid? _____Yes ____No
Have you even been convicted of a felony? _____Yes ____No
Do you have any handicaps or disabilities which need to be considered in the assignment of buildings? ______Yes ______No
If there are any special health considerations that may affect your performance in graduate school, please specify them:
___________________________________________________________________________________________
PURPOSE FOR GRADUATE STUDY STATEMENT
Attach a typed statement indicating your purpose in applying for graduate degree or CAS program study, identifying any particular area of special interest within the major field, your plans for future occupation and/or profession, and any additional information which may be of help in evaluating your preparation and your fitness for graduate study at Oswego.
____________________________________________________________________________________________
This application should be regarded as evidence that I seek the Master's Degree and/or Certificate of Advanced Study at the State University of New York at Oswego, and further, that this information furnished by me is true and accurate.
Signed_____________________________________________________________________ Date___________
This application and all other admission documents are to be submitted in one packet to:
Graduate Office\ State University of New York at Oswego\ Room 602 Culkin Hall\ Oswego, New York 13126
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