For Office Use Only
ID #: Program 1: Program 2: St Type: Level: Term: GRADUATE APPLICATION
I’m applying for: █ Summer █ Fall █ Winter █ Spring of 20_____
Personal Information
1. Name Last
Date: First & Middle
2. Date of Birth (mm/dd/yyyy)
/
3. Sex
█M █F
4. Other names that may appear in your documents
/
5. Social Security Number
-
6. Mailing Address: (House Number, Street or P.O. Box)
Apartment or unit #
State
City
-
Zip Code
7. Contact Phone Number
-
8. Country of Birth
9. Country of Citizenship
█
█
-
Home
Cell
Non-Citizens Visa Type
█ F-1 █ Permanent Resident
█ J-1 Other: 11. Religious Affiliation
10. E-mail
@
13. Ethnicity*
12. Marital Status*
█
Single
█
Married
█
Hispanic or Latino
█
14. Race*
Non-Hispanic/Latino
*The federal government requests that we collect the ethnicity/race data for statistical purposes, but your response is not required.
█ American Indian/Alaska Native █ Black/African American
█ Asian
█ Hawaiian/Pacific Islander
█ White
Education
15. Program you would like to apply for at La Sierra University (see reverse for list of programs)
Degree: █ MA █ MBA █ MPS █ MDiv █ MMin █ MAT
16. Colleges & universities attended
█ Cert █ Cred █ EdS █ EdD █ Non-Degree
City/State/Country
Dates Attended
Degrees Earned
( If you attended additional colleges, please submit in a separate sheet of paper. Thank you.)
Lifestyle
█ No █ Yes* 18. Have you ever been convicted of a crime?
(If “yes” to either of these questions, please explain in a separate sheet of paper.)
17. Have you ever been dismissed from school?
█ No █ Yes*
Personal Statement:
A Personal Statement is required for your application to be complete. Your Personal Statement of 250 words or more should describe your achievements, your
academic goals, and why you have chosen LSU for continued studies. Please e-mail your personal statement to [email protected].
Please read this statement before signing:
• I certify that the above information is complete and correct to the best of my knowledge.
• I authorize the University to verify the information I have provided as well as provide the University the right to review my education citizenship record.
• I further understand that this information will be relied upon by the officials of the University in determining my admission status and that the submission of false information is grounds for rejection of
my application, withdrawal of an offer of acceptance, cancellation of enrollment, and/or disciplinary action.
• If my application is accepted, I agree to abide by the policies, standards and regulations at La Sierra University and to respect the ideals, principles and traditions it upholds as a Seventh-day Adventist
Christian institution of higher learning. A summary of the University standards “Statement of Agreement” can be obtained online at www.lasierra.edu/statementofagreement.
• It is my responsibility to become familiar with the contents of the Student Handbook and the University Bulletin prior to enrollment.
I have read, and understand the statement above. My signature below indicates that I authorized for my application to be processed.
✍
SIGN HERE: DATE: Graduate Programs–
Post-Baccalaureate Programs
College of Arts and Sciences
English, MA
School of Business
Accounting, MBA
Finance, MBA
General Management, MBA
Human Resource Management, MBA
Marketing, MBA
Customized Concentration, MBA
School of Education
ADMINISTRATION AND LEADERSHIP
Administration and Leadership, MA
Administration and Leadership, EdS
Education (Administration & Leadership), EdD
Administrative Services—S.D.A., Cred
Preliminary Administrative Services—State, Cred
Professional Administrative Services—State, Cred
CURRICULUM AND INSTRUCTION
Curriculum and Instruction, MAT
Curriculum and Instruction, MA
Curriculum and Instruction, EdS
Special Education (Mild/Moderate Disabilities), MA
Education (Curriculum and Instruction), EdD
Elementary Teaching—S.D.A., Cred
Multiple Subject Teaching—State, Cred
Secondary Teaching—S.D.A., Cred
Single Subject Teaching—State, Cred
Educational Technology, Cert
EDUCATIONAL PSYCHOLOGY AND COUNSELING
Counseling, MA
Educational Psychology, EdS
Education (Educational Psychology & Counseling), EdD
School Psychology, EdS
Pupil Personnel Services/School Psychology—State, Cred
Guidance Counselor—S.D.A, Cred
School of Religion
Religion, MA
Pastoral Studies, MPS
Pastoral Studies, MDiv
Ministry, MMin
Ministry, Cert
LEGEND
Cert Certificate Program
CredCredentials
MA
Masters of Arts
MAT
Master of Arts in Teaching
MBA
Master of Business Administration
MPS
Master of Pastoral Studies
MDiv
Master of Divinity
MMin
Master of Ministry
EdS
Specialist in Education
EdD
Doctor of Education
S.D.A. Seventh-day Adventist
Majors as listed in the Bulletin
Mail completed applications to: Office of Admissions. La Sierra University. 4500 Riverwalk Pkwy. Riverside, CA 92515