Return This Form To

Return this form to:
University of North Texas
Toulouse Graduate School
Graduate Admission Section
1155 Union Circle #305459
Denton, TX 76203-5017
(940) 565-2383 ■ Fax (940) 565-2032 / Toulouse Graduate School
Application for Second
Bachelor’s Degree / Please indicate the semester and year for which the Second Bachelor’s degree is sought (check one semester only)
___ Fall 20____
___ Spring 20____
___ May Mini-mester 20____
___ Summer I 20____
___ Summer II 20____
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).
1.  Social Security Number (optional): / 2.  Date of birth: / 3.  Gender: □ Male
□ Female
4.  Name in full (Last, First, Middle, Maiden):
5.  Present mailing address:
City: / State: / Zip: / Texas County:
6.  Telephone: Home: / Cell: / Work: / Fax:
7.  Email address: / 8.  Place of birth:
9.  State of legal
residency: / 10.  If Texas, how long have you lived
at your present address? (months/years):
11.  If you have lived at your present address for less than 12 months, list your prior address: (Include length of time at this address)
12.  Are you a U.S. Citizen? □ YES
□ NO / 13.  If not a U.S. citizen, are you a permanent □ YES
resident of the United States? □ NO
14.  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.
Country of citizenship: / Resident alien number: / Date of adjudication:
15.  Ethnic background (optional): For reporting purposes only, we would appreciate your indicating which of the groups listed below best describes your ethnic background.
□ American Indian or Alaskan Native / □ Asian or Pacific Islander / □ Hispanic
□ African American, Black / □ White, non-Hispanic origin / □ Other
16.  Employment: List employers and employment dates for the last year.
Employer / Location / Date From / Date To
17.  What is your intended field of study for the second bachelor’s degree?
Do you intend to enroll in one of the UNT-Dallas campus programs? □ YES □ NO
Major (required; list only valid
undergraduate majors):
18.  Have you ever attended UNT? □ YES □ NO / If yes, list the semester
last enrolled at UNT:
19.  Have you enrolled at UNT
under another name? □ YES □ NO / If yes, print name:
20.  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.
Institution attended
(do not abbreviate) / City, State / Semester/Years attended (beginning – ending) / Degree / Date awarded/ expected
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.
21.  Are you presently attending another □ YES
college/university? □ NO / If yes, please list the name of the institution
(include semester and year enrolled):
22.  Are you currently on probation or □ YES
suspension at another institution? □ NO / If yes, please list the
name of the institution:
23.  Certification:
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.
Applicant’s signature: / Date:
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.
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.
I authorize the University of North Texas to charge my credit card for the appropriate non-refundable application fee.
Credit Card Type: □ MASTERCARD □ VISA □ DISCOVER □ AMERICAN EXPRESS
Card Number: / Expiration Date: (month/year)
Security Code: / Date:
Signature of Card Holder:
Printed Name of Card Holder: / Name of student if different than card holder: