WSU - 2004-2005 Graduate Catalog

2004-2005

Supplement to the 2002-2004 Graduate Catalog

Graduate Nondegree and Transient Application

September(fall)20__ January(winter)20__ March(spring)20__ June(summer)20__

Indicate month and year you wish to enroll if admitted

The following questions should be answered carefully and completely. Please type or print your information. Show "N/A" (not applicable) when appropriate. If the application form is submitted with essential information that is missing or illegible, it will be returned to you to be corrected, which will delay processing of your application. This form when completed must be signed and dated. All application materials become the property of the School of Graduate Studies and cannot be returned.

State law requires all state-assisted universities to charge nonresident fees to Ohio male students who have not registered with the Selective Service. If you were born after December 31, 1959, have not yet reached the age of 27 years, and have not registered with the Selective Service, you may do so at any United States Post Office.

PERSONAL INFORMATION

	Yes No
Social Security Number	Have you previously applied for graduate admission at Wright State University?

Legal or Family Name

First

Middle

Previous name(s), if any

Street address

City

State

Zip

Area Code/Phone

E-mail address

Business telephone number

Birthday/Month, day, year

Sex: Female Male

(This information is required by the federal government; however, reporting it on this form is strictly voluntary.)
Caucasian African-American Asian or Pacific Islander Hispanic
American Indian or Alaskan Native International

Yes No

On active military duty in Ohio or a dependent of such person

Yes No

Employed full time in Ohio

Yes No

Employed part time in Ohio

RESIDENCY INFORMATION

Country of citizenship _______________________ City and country of birth ______________________

State of residency ____________ If Ohio resident indicate county of permanent residence __________

Dates you have lived in Ohio: ___ Never; ___ From birth to present;
___ From month ___ year ___ to month ___ year ___

Are you a resident alien? _____ If yes, provide copy of Form I-151.

Are you a non-resident alien? _____
If yes, indicate visa and date of entry into the United States _______________________

ACADEMIC INFORMATION

1. Desired status: (Please check only one.)

Nondegree status

This status allows a student not desiring to pursue a degree program to take selected graduate courses. Admission into this status does not imply or guarantee subsequent admission into a degree program. However, should a student be accepted into degree status at a later date, a maximum of one-half (50%) of the graduate hours required for completion of degree requirements may consist of applicable graduate courses completed in nondegree status. A student desiring admission into a certificate program; e.g., Certificates of Anatomy, Quality Assurance, TESOL, etc., is also required to apply to the academic department offering the program. The student should contact the department for application procedures. A student, in this status, desiring to take graduate courses in the College of Education and Human Services for the purpose of updating or renewing teacher certification/licensure requirements will not have the same services provided by the college as if in certification status. A student, in this status, desiring to take graduate courses in business or nursing should check with the respective academic program advisors, as additional requirements may apply. ($10 application fee)

Transient Status

This status allows a student actively pursuing a graduate degree at another college/university to take graduate course work at Wright State. A ñPermission for Transient Statusî form must be submitted for each quarter the student intends to enroll. Each form must be officially certified, with seal, by the graduate dean of the home institution. ($10 application fee)

2. List in chronological order all colleges and universities, including WSU, that you have attended. Attach additional page if necessary.

College/University	City/State	Inclusive dates	Major	Degree/Date

X___________________________________________________________________________________

Signature Date

Do not write below ths line

RES R N F --------	APPLFEE --------	ADMSTATS ---------	CODE --------	GRADTEST ---------	RECMEND --------
ENTR C R N ---------	Y N W DEGRSTAT -------- D N C T	N P A C R I TRANPRMT --------- Y N	1 CK_______ 2 LT_______ 3 TS_______ 4 CC_______	GRE GMAT Miller PURSTUDY -------- Y N	1 2 3 REF --------- 1 2 3

Major #_________________________ PERMRESCARD Y N NURLICNS Y N Y N NURLICNS Y N

School of Graduate Studies
E344 Student Union
Voice: (937) 775-2976
Fax: (937) 775-2453
E-mail: wsugrad@wright.edu

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