Part I Application for Graduate Admission

PART I APPLICATION FOR GRADUATE ADMISSION

DOCTORATE IN COUNSELOR EDUCATION AT TEXAS A&M-CORPUS CHRISTI

Please type or complete using blue or black ink. Please submit two copies.

Social Security No.
Full Legal Name LAST / FIRST / MIDDLE
Names under which you were last registered, if different than above:
Addresses and telephone numbers (Notify both the Admissions Office and the department promptly if these change):
Permanent:
No. & Street or PO Box / City / State / Zip Code / Area Code & Phone Number
Mailing:
(If different from above) No. & Street or PO Box / City / State / Zip Code / Area Code & Phone Number
E-mail address:
Emergency Contact:
Name / Address / City / State / Zip / Area Code & Phone No.
Date of Birth: / Birth place: / Sex:
MM DD YY City State Country

Ethnicity. This information is used for state and federal reporting purposes only and will not be used in any admissions decisions. Completion of this question is optional.

О African American or Black, not of Hispanic origin О Hispanic, Chicano, Mexican American, or Latino

О American Indian or Alaskan Native О White, not of Hispanic Origin

О Asian or Pacific Islander О I do not wish to provide this information.

О Multiracial. Indicate other ethnic or racial terms that further or better describe your ethnic background.

Have you ever applied for graduate status at Texas A&M-Corpus Christi? No _____ Yes _____ If yes, when? ______

For which term are you applying? Fall Year ______

List in chronological order all undergraduate and postbaccalaureate schools attended or being attended, including Texas A&M-Corpus Christi. Include whether semester (S) or quarter (Q) hours. Calculate your grade point average. Consider A as 4 points, B as 3, C as 2, D as 1, F as 0. (Your exact average will be calculated before final action is taken by this Graduate School.)

/ School Name, City & State / Zip Code Required / Dates of Attendance / Degree & Date Conferred / Overall GPA / Office /
Hours / Pnts / Ave /
Under
Graduate / 1)
2)
3)
4)
5)
Postbaccalaureate / 1)
2)
3)

List below all courses in progress, including extension and correspondence courses: School Name ______

Course Title & Number / Credit
Hour / Estimated Grade / Course Title & Number
(Continued) / Credit
Hour / Estimated
Grade
1) / 3)
2) / 4)

I have read the instructions and hereby certify that to the best of my knowledge the information furnished on this form is true and complete. I understand that if found to be otherwise, it is sufficient cause for refusal or dismissal.

Date: ______Applicant Signature: ______