General Information Status: Degree Seeking Special

General Information Status: ○ degree seeking ○ special

○ Mr. ○ Mrs. ○ Ms. (check) Enrollment Term: ○ Spring ○ Summer ○ Fall Year:

Degree Program: ○ MBA ○ IMBA ○ MAcc ○ MBA Plus Campus I am applying to:

Are you interested in attending online? ○ Yes ○ No

Full Legal Name (First, Middle, Last) Maiden Preferred Name

Home Address Apt. Number City State Zip Phone

Date of Birth Place of Birth City, State, Country E-mail Address

Country of Citizenship Visa Status

Social Security Number Religion (optional) Ethnic Origin (optional) Marital Status

Have you ever attended Gardner-Webb? ○ Yes ○ No If so, date you last attended

Have you ever been dismissed from any school for disciplinary reasons? ○ Yes ○ No

Have you ever been charged with a felony? ○ Yes ○ No

Have you ever been convicted of, or pleaded guilty to, a felony? ○ Yes ○ No

Colleges Attended

Please list all colleges and universities attended, beginning with the most recent. Note that an official transcript must be submitted for each institution.

College/University / Location / Dates Attended / Major / Degrees Received
/ / to / /
/ / to / /
/ / to / /
/ / to / /
/ / to / /

Have you taken the GMAT? ○ Yes (Score ) ○ No

Employment (Complete all information below, if applicable)

Employer Name / Work Phone / Company Location / Position/Title / Dates of Employment
/ / to / /
/ / to / /
/ / to / /

Briefly describe your duties

Professional/Community Involvement

List all professional or community organizations with which you are affiliated, indicating offices held and dates involvement. Note any significant awards, achievements, or certifications.

Survey Information

Do you receive tuition reimbursement? ○ Yes ○ No If yes, % or $ per year?

Who or what attracted you to Gardner-Webb University’s Graduate School of Business?

Transcripts and other documents

Official transcripts for all undergraduate and graduate work should be sent directly from you school to the address below. Your completed application, with a $40 application fee, should be sent to this address as well. You will be contacted regarding your application status after receipt of both application and transcripts. Application is also available online. In addition you must forward a current resume. Additional documents are required for admission processing. Visit the website for further details.

Gardner-Webb University

Graduate School of Business, Director of Admissions

PO Box 7256

Boiling Springs, NC 28017

I understand that I must submit complete official transcripts from all colleges, or universities attended. I certify that, to the best of my knowledge, all statements I have made in this application are complete and true. Incomplete or false information may result in the denial of this application or in my subsequent dismissal from Gardner-Webb University.

Signature Date

Gardner-Webb University admits students without regard to religious creed, race, sex, ethnicity, national origin, handicap, age, or veteran’s status.

Contact Information:

Gardner-Webb University

Graduate School of Business

Director of Admissions

PO Box 7256

Boiling Springs, NC 28017

Phone: (800) 457-4622 or (704) 406-4489; Fax: (704) 406-3895

Website: www.gradbiz.gardner-webb.edu

E-mail address: