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Domestic Graduate Application
Before you complete this application, please, read the instructions associated with this form. There are still materials that will have to be sent via regular mail, such as: transcripts, GRE/ GMAT scores, photocopies of alien registration cards, etc. You must also include the signature sheet, before your application can be considered. Make sure all information is accurate and up to date before you submit this form. If you still have question, please contact: chemsele@uno.edu

Last modified:  01/25/2006
What semester and year do you plan to begin? Spring Summer Fall
Name Last First Middle Jr. III, etc
Other first or last name used on transcripts or records
Predominant Ethnic Origin (required) SSN (###-##-####)
Sex Male Female Birthday (##/##/19##) Veteran Yes No
Country of Citizenship Religion (Optional)
Are you applying for financial aid? Yes No Assistantship Only
Permanent Home Address Parish/County
City State Zip Code Country (if not USA)
Mailing Address Parish/County
City State Zip Code
Home Phone Number (###-###-####) Daytime Phone Number
Fax Number E-mail Address
Non-U.S. citizen, indicate type of Visa *copy both sides Other
Place of Birth City State Country
Have you ever attended, registered and/or paid fees at UNO? Yes No
If yes, did you attend Undergraduate Graduate School
If no, have you ever applied to the UNO Graduate School before? Yes No
If yes, when?
List below all colleges you attended in chronolgical order (INCLUDING UNO). All institutions must be listed regardless of whether credit was earned or is desired. YOU are required to have complete OFFICIAL transcripts mailed to this office directly from all schools attended.
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 Name of School City and State Grad. Date Degree Earned Attended From Attended To
-
-
-
Month. Year
-
Month. Year
Month. Year
(College)
(College)
(College)
(College)
Are you currently enrolled in college? Yes No
When do you plan to complete this enrollment?
Will you be pursuing a graduate degree at UNO? Yes No
If yes, indicate your proposed program of study:
Program Specify research area Degree
If no, state your intentions: Other
Have you taken the Graduate Record Exam (GRE)? Yes No
Test Date (mo./yr.) Scores: Verbal Quantative Analytical
Have you taken the Graduate Management Admissions Test (GMAT)? Yes No
Test Date (mo./yr.) Scores:
Have you taken the TOEFL (required for international students)? Yes No
Test Date (mo./yr.) Scores:
Please request that your scores be sent to our office. Failure to take available test may result in delay or denial of admission.
RESIDENCY (Failure to answer these questions may result in a non-resident fee clasification)
When did you move to your present address? Month Day Year
If you have been living at your present address less than two years, list you rhome address for the past two years (attach addendum if necessary).
Number & Street, City, State Since (mo./yr.)
Number & Street, City, State Since (mo./yr.)
Number & Street, City, State Since (mo./yr.)
Number & Street, City, State Since (mo./yr.)
Do your parents reside in Louisiana? Yes No
If yes, indicate dates of residence: From (mo./yr.) To (mo./yr.)
If you are, or have been, on active duty in the armed forces, please indicate:
Date Entered (##/##/19##) State Date Released State
Are you a dependent of a member of the armed forces on active duty stationed in Louisiana? Yes No
List all employment in Louisiana for the last (5) years. (Attach addendum if necessary.)
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Name of Employer
City
Worked From
Worked To
-
-
-
Month. Year
Month. Year
(Employer 1)
(Employer 2)
(Employer 3)
(Employer 4)
Have you ever been convicted, pled guilty, or are you presently charged by indictment or information with a crime (felony) which might be punishable by imprisonment in a penitentiary? Yes No
If yes, have you ever been committed to a correctional or training institution? Yes No
Have you ever been suspended or dismissed from any college or university for scholastic or disciplinary reasons? Yes No
If yes, give name of institution, date, and reason for this action:
How did you first learn about UNO?
Have you enclosed the $20 application fee ($50 if submitted after deadline)? If charging the application fee to a credit card, see Application Fees/Deadlines.
If you are paying the application fee in person, be sure to return the original application to the Office of Admissions after fee payment.
Have you answered all questions?