Return this form to: - University of North Texas
|Return this form to: |[pic] |Please indicate the semester and year for which|
| | |the Second Bachelor’s degree is sought (check |
|University of North Texas |Toulouse Graduate School |one semester only) |
|Toulouse Graduate School |Application for Second | |
|Graduate Admission Section |Bachelor’s Degree |___ Fall 20____ |
|1155 Union Circle #305459 | |___ Spring 20____ |
|Denton, TX 76203-5017 | |___ May Mini-mester 20____ |
|(940) 565-2383 ■ Fax (940) 565-2032 | |___ Summer I 20____ |
| | |___ Summer II 20____ |
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|This application is valid only for U.S. citizens and permanent resident aliens. |
|All applications must be submitted with a non-refundable application fee of $75 |
|(check, money order or credit card authorization). |
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|Social Security Number (optional): |Date of birth: |Gender: □ Male |
| | |□ Female |
|Name in full (Last, First, Middle, Maiden): |
|Present mailing address: |
|City: |State: |Zip: |Texas County: |
|Telephone: Home: |Cell: |Work: |Fax: |
|Email address: |Place of birth: |
|State of legal |If Texas, how long have you lived |
|residency: |at your present address? (months/years): |
|If you have lived at your present address for less than 12 months, list your prior address: (Include length of time at this address) |
|Are you a U.S. Citizen? □ YES |If not a U.S. citizen, are you a permanent □ YES |
|□ NO |resident of the United States? □ NO |
|If you are a permanent resident, please attach a copy of the front and back of your resident alien card. For tuition classification purposes, you may be required to |
|present the card in person at a later time for verification. |
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|Country of citizenship: |
|Resident alien number: |
|Date of adjudication: |
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|Ethnic background (optional): For reporting purposes only, we would appreciate your indicating which of the groups listed below best describes your ethnic background. |
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|□ American Indian or Alaskan Native |
|□ Asian or Pacific Islander |
|□ Hispanic |
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|□ African American, Black |
|□ White, non-Hispanic origin |
|□ Other |
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|Employment: List employers and employment dates for the last year. |
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|Employer |
|Location |
|Date From |
|Date To |
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|What is your intended field of study for the second bachelor’s degree? |
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|Do you intend to enroll in one of the UNT-Dallas campus programs? □ YES □ NO |
|Major (required; list only valid |
|undergraduate majors): |
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|Have you ever attended UNT? □ YES □ NO |If yes, list the semester | |
| |last enrolled at UNT: | |
|Have you enrolled at UNT |If yes, print name: |
|under another name? □ YES □ NO | |
|College record: List below all college/universities in which you have been officially registered. List most recent first. Do not abbreviate. Failure to list all |
|colleges will be considered an intentional omission and lead to forced withdrawal. |
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|Institution attended |
|(do not abbreviate) |
|City, State |
|Semester/Years attended (beginning – ending) |
|Degree |
|Date awarded/ expected |
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|An official transcript from each school listed other than UNT must be submitted. Former UNT students who submitted transcripts from other schools need not resubmit |
|those transcripts unless contacted by our office. Your application can be processed only after all necessary credentials have been received. Official transcripts, |
|once submitted, are the property of the university and cannot be returned. |
|Are you presently attending another □ YES |If yes, please list the name of the institution |
|college/university? □ NO |(include semester and year enrolled): |
|Are you currently on probation or □ YES |If yes, please list the |
|suspension at another institution? □ NO |name of the institution: |
| Certification: |
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|I certify that all information given on this application is complete and correct and may be used to determine my admission status and my residency eligibility. I |
|authorize the university to verify the information I have provided. I agree to notify the proper officials of the institution of any changes in the information |
|provided. I understand that falsification or omission of any of the academic or residency information will void my admission, cancel my enrollment, and/or result in |
|appropriate disciplinary action. I authorize the University of North Texas to charge my credit card for the appropriate non-refundable application fee. |
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|Applicant’s signature: |
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|Date: |
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|The application for admission to the second bachelor’s program at the UNT Graduate School should be submitted, with official transcripts, at least two months |
|prior to the semester of enrollment. All students are encouraged to apply as early as possible. If application materials are received after the deadline, |
|applications may experience delays in processing and may be subject to late registration and a late registration fee. Only written notice from the dean of the |
|UNT Graduate School constitutes approval of admission, not correspondence with department chairs or with individual faculty members. |
|Immunization is an integral part of your health care. You should make sure that your immunizations for measles, tetanus and poliomyelitis are current. Please |
|contact your physician for more information. |
|It is the policy of the University of North Texas not to discriminate on the basis of race, color, religion, sex, age, national origin, disability (where |
|reasonable accommodations can be made), disabled veteran status or veteran of Vietnam era status in its educational programs, activities, admissions or employment|
|policies. In addition to complying with federal and state equal opportunity laws and regulations, the university through its diversity policy declares harassment|
|based on individual differences (including sexual orientation) inconsistent with its mission and educational goals. Direct questions or concerns to the equal |
|opportunity office, 9940) 565-2456, or the dean of students, 9940) 565-2648. TDD access is available through Relay Texas: (800) 735-2989. |
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|Credit Card Authorization |
|All applications must be submitted with a non-refundable application fee of $75 (check, money order or credit card authorization). Make checks and money orders |
|payable to UNT. |
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|I authorize the University of North Texas to charge my credit card for the appropriate non-refundable application fee. |
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|Credit Card Type: □ MASTERCARD □ VISA □ DISCOVER □ AMERICAN EXPRESS |
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|Card Number: |
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|Expiration Date: (month/year) |
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|Security Code: |
|Date: |
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|Signature of Card Holder: |
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|Printed Name of Card Holder: |
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|Name of student if different than card holder: |
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For office use only
Blocks____________________
Last Semester______________
Citizenship_________________
For office use only
c k m r x i
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