Application for Graduate Admission

All materials submitted in conjunction with an application become the property of Georgia Southwestern State University and will not be returned.

I. Personal Information

Providing your Social Security number will facilitate the review of your application for determining tuition classification status and matching your application with other schools records including but not limited to transcripts and financial aid applications. 

Other Names
(if different from above) or other name(s) that appear on your records
 
 
Mailing Address
Address to which all admission correspondence should be mailed
                 
Permanent Address
                 
Contact Information
Emergency Contact
       
Please answer the following questions
What is your race? (choose one or more)




If yes, please explain
Are there any criminal charges currently pending against you?*
If yes, please explain
Have you entered a plea of guilty, a plea of no contest, a plea of nolo contendere, and Alford plea to a criminal charge, or a plea under a first offender act?*
If yes, please explain
Have you ever been suspended from another college or university?*
If yes, please explain
Have you ever been disciplined, suspended, or expelled for a conduct code violation from a post-secondary educational institution?*
If yes, please explain
What is the highest level of education obtained by your parent(s)/guardian(s)?
Place of Birth
If United States,

II. Enrollment Information

*
Please Indicate all Colleges Attended
Name of Institution* City/State* Years of Attendance* Graduation (Month/Year)* Degree Earned*
If so, date taken

If so, date taken

III. Tuition Classification

If you have ever lived outside the state of Georgia and now live in Georgia, how long have you continuously lived in the state of Georgia at this time?
   
If you have a drivers license, in which state was it issued?
If you are registered to vote, which state are you registered to vote in?
If you are a non-resident alien or permanent resident, please complete the remainder of this section, otherwise SKIP to Military Information Section.

IV. Military Information

If yes, and status

Are you the spouse or dependent child under the age of 24 of someone who is currently active duty, a veteran, a member of the National Guard, or a Reservist in the US Armed Forces?*

If yes, please specify branch of military member and status

Is the military member stationed in Georgia?