Part A: Student Information
Current Street Address (Line1):
Street Address (Line2):
Home Phone Number:
Work Phone Number
Date of Birth (MM/DD/YYYY):
Where have you lived during the past twelve months? (give dates)
Part B: Educational Background
Name of High School:
Street Address and State of High School:
University granting Bachelor's Degree:
University granting Master’s degree:
List all colleges/universities attended (where you enrolled for graduate courses) since receiving your bachelor's degree. (Failure to do so may result in dismissal):
If so, when and for what reason?
If so, when(MM/YYYY):
If yes, what college?
If you began a degree program and discontinued graduate study, state reasons for discontinuing:
Part C: Occupational Data
If yes, specify state?
Beginning with latest date, list experience for the past five years:
Title of Position
Part D: Professional Objective
How did you learn about Northern?
WHAT PROGRAM DO YOU PLAN TO FOLLOW?
You have to choose a Major.
What year do you plan to begin Graduate Study?
I hereby certify that the information on this application is accurate in every respect and I understand that any intentional misrepresentation may be cause for revocation of admission. I also certify that I will inform the Office of Graduate Studies of any change in the above record which occurs between now and the opening date of the term for which I am applying. I agree to comply with the regulations and requirements of Northern State University and to cooperate with the authorities and any fellow students to maintain high standards of conduct and scholarship. It is understood that I accept registration as a student at Northern State University subject to the above provisions. Enrollment in classes offered through extension is open to all qualified students without official admission to the university or a college program, but enrollment by this method does not constitute admission.
Check this box to agree to the Application Agreement in the prior paragraph.
Please Check The Checkbox
PROVIDE 2 LETTERS OF RECOMMENDATION (3 IF APPLYING FOR A GRADUATE ASSISTANTSHIP). REQUEST ONE OFFICIAL COPY OF YOUR TRANSCRIPT TO BE SENT TO THE OFFICE OF GRADUATE STUDIES. A $35.00 NON-REFUNDABLE MATRICULATION FEE MUST BE PAID BEFORE ADMISSION CAN BE CONSIDERED. Please return to the Office of Graduate Studies, NSU, 1200 S Jay Street, Aberdeen, SD 57401. Northern State University is an equal opportunity institution. The policy of Northern State University is to provide equal opportunities for employment, admissions, and services to all individuals. Contact the affirmative action office on campus in the Administration Building, Room 213. Phone 605-626-2520.
Are you Hispanic or Latino?
Check one or more of the following races:
For Office Use Only
GPA Last 64 Sem:_______________
GPA in Major:__________________
Senior Prov. Accpt:______________