Please indicate the semester and
year for which the Second Bachelor’s
degree is sought (check one
semester only)
Return this form to:
University of North Texas
Toulouse Graduate School
Admission Section
1155 Union Circle #305459
Denton, TX 76203-5017
(940) 565-2383 ■ Fax (940) 565-2032
___ Fall 20____
___ Spring 20____
___ May Mini-mester 20____
___ Summer I 20____
___ Summer II 20____
Toulouse Graduate School
Application for Second
Bachelor’s Degree
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):
For office use only
Blocks____________________
Last Semester______________
Citizenship_________________
For office use only
c k m r x i
#____________ dt___________
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:
9. State of legal
residency:
8. Place of birth:
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
resident of the United States?
□ YES
□ 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
□ African American, Black
□ Asian or Pacific Islander
□ White, non-Hispanic origin
□ Hispanic
□ Other
16. Employment: List employers and employment dates for the last year.
Employer
Location
Date From
Date To
17. Have you ever plead guilty, no content, or been referred for deferred adjudication and/or been convicted of a criminal
offense other than a minor traffic violation or do you have criminal charges pending against you at this time?
□ YES □ NO
If admitted, will you be required by law to register as a sex offender with the University of North Texas Police Department?
□ YES □ NO
18. 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):
19. Have you ever attended UNT? □ YES
□ NO
20. Have you enrolled at UNT
under another name?
□ NO
If yes, list the semester
last enrolled at UNT:
If yes, print name:
□ YES
21. 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.
22. Are you presently attending another
college/university?
□ YES
□ NO
If yes, please list the name of the institution
(include semester and year enrolled):
23. Are you currently on probation or
suspension at another institution?
□ YES
□ NO
If yes, please list the
name of the institution:
24. 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
Card Number:
Security Code:
□ VISA □
DISCOVER
□ AMERICAN EXPRESS
Expiration Date: (month/year)
Date:
Signature of Card Holder:
Printed Name of Card Holder:
Name of student if different than card
holder: