Application for Graduate Study
Related Files: Application Instructions | Codes | Equal Opportunity Policy

Application Fee (Non-refundable): $45.00

For Office Use Only

 |      |      |     |       |       |       |

IDENTIFICATION NUMBER

PRINT OR TYPE

(Use codes where indicated)


SOCIAL SECURITY NUMBER:
_________/______/__________

Application for (semester and year)
Fall 20__   Spring 20__   Summer 20__

Date of birth
______/______/______
Month /   Day  /   Year

Gender (optional)  [     ]  Male      [     ] Female

Legal name   [     ] Mr.     [     ] Ms. 

Name:_________________________
                
Last (family or surname) name

___________________
First name

_____________________
Middle

_______________________
Previous last name(s)

 

Permanent address:_______________________________________________________________________________________
                                                                                                               
Number and street

City: _________________________ State/Country: ______________________ Zip code: _________________________

 

Mailing address: ________________________________________________________________________________________
                                                                                                              
Number and Street

City: _________________________ State/Country: ______________________ Zip code: _________________________

 

Day phone no.: (____)  _____- ________  Home phone no.:  (____)  _____- ________  E-Mail address:__________________

 

Fax no.:  (____)  _____- ________

 


 

 

[     ] U.S. citizen

[     ] Permanent resident

Citizenship
[__________]
 
U.S. State or Country 

Birthplace
[__________]
 
U.S. State or Country

[    ] VISA___Type

Are you a veteran of the U.S. Uniformed Services?      [     ] Yes                   [     ] No                During Vietnam [     ]

 


College/School
[__________]
C Codes

Major
[__________]
C Codes

Degree sought
[__________]
D Codes

Indicate specific program within
the department
______________________________

Classification:   [     ] Regular        [     ] Unclassified (non-degree)

 

 

Status: [     ] New entrant     [     ] Transfer     [     ] FSR (Former student returning)

 

 Enrollment:   [     ] Fulltime        [     ] Part Time

 


List all universities and colleges attended. List institutions where highest degree was obtained first.
Howard University students: List Howard University and all other institutions.

 

Institution

City

State

Country

Major

Degree
received

Dates

 

From Mo/Yr

To Mo/Yr

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Have you previously applied for admission to Howard University?    [     ]  Yes     [     ]  No
If Yes, for which semester was last application submitted:  Fall 20 ______      Spring 20 _____     Summer 20 _____

Former Howard University students indicate last semester enrolled:    Fall 20 _____    Spring 20 ____   Summer 20 ____

Howard University school/college in which you were last enrolled: C Codes[__________]   Major C Codes[________]
Howard University identification number (ID): ____________________


NAME UNDER WHICH YOU LAST ATTENDED HOWARD UNIVERSITY IF DIFFERENT FROM NAME
PRESENTLY USED.


__________________________________________________________
Last


___________________________________________________________
First


_______
MI

If you answer yes to any of the next four (4) questions, attach a letter explaining details.

a)  Have you been arrested? [    ] Yes [    ] No
b)  Have you been convicted of any crime ( other than traffic violations ) or been sentenced to a correctional or penal Institution? [    ] Yes [    ] No
c)  Has disciplinary action been taken against you at any educational institution? [    ] Yes [    ] No
d)  Has academic action been taken against you at any educational institution attended? [    ] Yes [    ] No

What most influenced your decision to attend Howard UniversityE Codes[__________]

List family members (exclude spouse) who have attended Howard University. (optional)

____________________________________________________________
Name

_____________________________________________________
Relation

________________
Class of

____________________________________________________________
Name

_____________________________________________________
Relation

________________
Class of

____________________________________________________________
Name

_____________________________________________________
Relation

________________
Class of


 

 

As indicated by my signature, I understand that withholding information required on this application or giving false information may make me ineligible for admission to the University or subject to dismissal when the same is made known regardless of classification. With this understanding, I certify that all of the above statements and information included are correct and complete; and, if admitted to Howard University, I agree to abide by its policies, rules and regulations.

 

Signature of applicant __________________________________________________________ Date ________________________________________

 

 

 

 

Please return the completed form, $45 application fee check or money order made (payable to Howard University) and required application materials directly to:

Office of Graduate Recruitment and Admissions

Howard University

Fourth and College Streets NW

Washington, DC 20059

 

             

     |GS -Home  | Admission |Graduate Program | Special Program | Financial Support | |Rules-and-Regulations | Archives |

Feedback |  |GS-Resources| GS- Bulletin | Search |

    2002- Howard University