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APPLICATION FOR ADMISSION TO GRADUATE DEGREE AND CERTIFICATE PROGRAMS

Please indicate the degree or certificate you wish to pursue:

GRADUATE DEGREES

CERTIFICATES

Management/Leadership Certificate (MLC)
Human Resource Management Certificate (HRC)
Research Administration Certificate (RAC)
Biopharmaceutical Leadership Certificate (BPC)

LOCATION & TERM

* Anticipated Start Year:* Semester:

NAME

* Last Name:* First Name:Middle Name:Previous/Maiden Name:

Mailing Address

* Permanent Street Address: * City/Town: * State/Province: * Zip/Postal Code:
* Country (if not in U.S.):* Home Phone Number:
(including area code)
Cell Phone(including area code):* E-mail:

Personal Information

* Social Security Number:Date of Birth(MM/DD/YYYY):

Emergency Contact

*Name:*Relationship:*Phone Number:

PREVIOUS EDUCATION

Official transcripts from all regionally accredited academic institutions attended are required. Transcripts must show the completion of a bachelor's degree from a regionally accredited institution. For Master of Science in Nursing applicants, transcripts must show the completion of a Bachelor of Science in Nursing (BSN) from a National League for Nursing (NLN) or Commission on Collegiate Nursing Education (CCNE) accredited institution. A GPA of 3.0 or above is generally expected for acceptance to the graduate nursing program. Note that a cumulative undergraduate GPA of 2.5 or above is generally expected for acceptance to the graduate management and graduate education programs. International transcripts must be translated into English and/or evaluated by a certified credential evaluation service.

From which regionally accredited college/university/institution did you receive your bachelor's degree?

Name of Institution:Date of Graduation:

List any additional undergraduate and graduate colleges/universities/institutions attended: Official transcripts will be required for all regionally accredited institutions attended. Please note that a cumulative GPA of 2.5 or above is generally expected for acceptance to the graduate programs.

Institution: Dates Attended:Approximate # of Courses:Degree Earned:

Institution: Dates Attended:Approximate # of Courses:Degree Earned:

Institution: Dates Attended:Approximate # of Courses:Degree Earned:

Have you ever attended Emmanuel College? Yes No

EMPLOYMENT HISTORY

Current Employer:Position:Date of hire:Employer Street Address: City: State:Zip Code: Work Phone:Fax: Work E-mail:

Name of Former Employer:Position Held:Employer Street Address: City: State:Zip Code: Dates Employed:

How did you first hear about Emmanuel College?
If other, please give source:

Does your employer offer tuition reimbursement?

Yes No Unsure

If yes, what is the annual limit?
Do you intend to apply for financial assistance? Yes No

All application materials must be submitted prior to being reviewed for acceptance and considered for financial aid.

OPTIONAL INFORMATION

Religion:

Are you Hispanic/Latino (including Spain)?
Yes
No

Ethnic Origin (select one):
American Indian or Alaska Native (including all Original Peoples of the Americas)
Asian (including Indian subcontinent and Philippines)
Black or African American (including Africa and Caribbean)
Native Hawaiian or Other Pacific Islander (Original Peoples)
White (including Middle Eastern)

CERTIFICATION OF INFORMATION

In consideration of the undertaking by the Office of Graduate & Professional Programs to process this form, I agree that the information furnished in this application for admission, together with all information and materials of any kind received by the Office of Graduate & Professional Programs from any source or prepared by anyone at its request, shall be completely confidential and shall not be disclosed to anyone including me and my family, except for situations specified in the Family Rights and Privacy Act of 1975.

I understand that I am responsible for the submission of official transcripts of my academic records. Only those transcripts issued directly by the Registrar of each institution will be accepted.

Formal admission to Emmanuel College as a graduate degree or certificate candidate is granted only after all admission materials have been received and all minimum standards are met.

I certify that the information provided in this application for admission are true and correct. I further authorize Emmanuel College to make appropriate inquiries when necessary to certify the accuracy of my records.

Emmanuel College is accredited by the New England Association of Schools and Colleges, Inc.

Emmanuel College admits students of any race, color, religion, national or ethnic origin, handicap, or sexual orientation to all rights, programs and activities generally accorded or made available to students at the College. The College maintains a policy of nondiscrimination toward all persons eligible to apply for scholarship and loan programs and other College-administered programs.

By checking this box and submitting this form, I agree to the above.