Application for Admission Gradua

Application for Admission
Graduate Management Certificate or
Masters of Arts in Human Resource Management

If you need help or have any questions, please call us at 1-800-662-3303 ext. 5200 or 712-279-5200

*Required Fields

General Information

*	Check the term you want to begin
	Fall	Year

	Type of Admission Requested
	Non-Degree Status Degree Status
	Is this your initial request for admission to graduate study at Briar Cliff University? Yes No
	If you have applied for admission to graduate studies previously, indicate term or year

Personal Information

Last Name

* First Name

Middle Name

Home Address

*	City		* State	* Zip
*	Home Phone		Cell Phone

*	Social Security

*	Date of Birth	City of Birth		State of Birth
	Country of Birth		Country of Citizenship
	If you are a permanent resident alien (PRA), list your PRA Number

*	Marital Status		Maiden or Former Name

*	Gender Male Female

	E-mail Address


Race (optional)
African American	Asian American	Caucasian American	Prefer not to Respond
Native American	Hispanic/Latino/American	International Student

Religious Affiliation (optional)

Military Experience Veteran Non-Veteran Now in Service Military Training Location Other

Do you expect to receive any VA benefits while attending BCU? Yes No



Do you expect to be employed while attending graduate school? Yes No
Employer		Office Phone
Position
City		State	Zip
Can you conveniently receive calls at work? Yes No

Education

College and Other Schools (including military training)
School	City	State	Years Attended
			to
			to
			to
			to
			to


	Please indicate which of the following computer-based skills you feel competent in: Word Processing Literature Searching Web-based Searches Spreadsheets or Databases

It is hereby certified that the information given in this application is true and correct. It is understood that misrepresentation, omission of information, or failure to answer any single question may cause delay or cancellation of admission. For the purpose of determining admission, I hereby authorize any educational institution, which I have previously attended, and officials at such institutions to release academic and disciplinary records and to discuss these records with appropriate officials at Briar Cliff University.

I accept the right of the Graduate School to exercise academic sanctions against me in the event that I fail to:

Provide official transcripts as required.
Meet academic or other criteria for admission to the program of my choice as required by the academic department. I fully understand that any waiver of admission requirements can only be granted by the Graduate school. No statements made by any other person regarding waiver of admission requirements shall in any way bind the Graduate School.

This information is sought for the purpose of considering your request for admission to the University. Only with your permission will information be released to a third party.

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