Admission-Application-for-Graduate-Programs+(Fillable)

BORICUA COLLEGE A P P L I C A T Graduate Admissions Manhattan Campus 3755 Broadway New York, NY 10032 212-694-1000 isanchez@boricuacollege.edu Bronx Campus Center 890 Washington Avenue Bronx, NY 10451 347-964-8600 brodriguez@boricuacollege.edu Brooklyn Campus Center Graham Ave Brooklyn, NY 11206 718-963-4112 amorales@boricuacollege.edu Boricua College is accredited by the Middle States Commission on Higher Education I O N PERSONAL INFORMATION: Legal Name: Last (Family Name) First (Given Name) Middle Name Maiden Name: _ (If Applicable) Gender: Male Female Date of Birth: _ / _ / _ Address: _ Street Name Apt Number City State Zip Code Country Cell Phone: - - Alternate Phone: - - Email Address: ENROLLMENT INFORMATION: APPLYING AS: Transfer Re-Admit Continuing I am interested in: MASTER DEGREE Human Services Education-TESOL Latin American & Caribbean Studies INTENDED MAJOR: I will register for: Time: Fall of 20 (Sept.) Spring of 20 (Jan.) Evening Campus/Location of Choice: Manhattan Bronx Brooklyn EDUCATIONAL INFORMATION: What will be your academic status at the time of enrollment? I have earned a degree from Boricua College I have earned a degree from another college or university Please list below all the college(s) you have attended: School Name Dates Attended _ _ College Graduation Date: Degree Earned: _ Major: _ DEMOGRAPHIC INFORMATION: Marital Status: Single Separated/ Divorced Date: _ Married Date: _ Widowed Date: _ Immigration Status: U.S Citizen U.S Permanent Resident F-1 Student Status Place of Birth: Ethnicity: Hispanic/Puerto Rican African American Primary Language: Hispanic/Dominican Hispanic/Other Asian Other White Country of Origin: _ Emergency Contact: Name Relationship to Student Phone Number Military Service? No Yes If yes, please provide DD214/Military Separation Form Medical Conditions? No Yes If yes, explain condition below: _ _ Are you disabled? No Yes _ _ _ _ _ _ _ _ _ _ _ _ _ Disciplinary Questions: _ Have you ever been suspended , removed, dismissed or expelled from any school or _ academic institution? _ _ No Yes _ If yes, please explain why _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ever been _convicted _ Have you of any felony, misdemeanor or other crime? (Omit traffic _ _ _ offenses) _ _ _ _Yes_ If yes, please describe offense and date of offense below: _No _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _to either NOTE:_Answering yes of the two questions does not automatically bar you from _ _ _ _ admission to Boricua College _ _ _ _ _ _ _ _ _ _ _ If yes, please describe below and provide documentation REFERRAL INFORMATION: How did you hear about Boricua College? Current Boricua College Student Direct Mail _ _ Friend/Family Member _ Open House/College Fair _ _ _ _ Co-worker _ Newspaper/Other Advertisement _ _ _ _ _ Guidance or College Counselor _ Employer _ _ _ _ _ _ _ _ _ Flyer/Tabling Boricua Alumni Association _ _ _ _ _ _ _ _ _ _ _ Walk-in _ _ Online _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ What_ are the most important reasons for choosing to_ _attend Boricua College? (check all _ _ _ _ that _ apply) _ _ _ _ _ _ _ _ _ _ _ _ _ _ Academic Major _ _ _ Small Class Size Colloquium _ _ _ _ _ _ _ _ _ Career Advancement _ _ _ Individualized Instruction _ _ _ _ _ _ _ _ _ _ _ _ Recommended by Friend/Family _ Convenient Location _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Personal Growth Academic Reputation _ _ _ _ _ _ _ _ _ _ _ _ _ _ Faculty – Education Facilitators _ _ Educational Model _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PERSONAL ESSAY GUIDELINES _ _ _ _ _ _ _ _ _ _ _ _ _ Please answer the following questions (350 words minimum) You must type your _ _ _ _ _ _ _ _ response and be sure to include relevant details _ _ _ _ _ _ _ _ _ _ _ _ 1)_ Why are you pursuing a master’s degree (in TESOL or Human Services) with _ _ _ _ _ _ _ Boricua College? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2)_ What are the most critical issues in your field _ today? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3)_ Describe how your professional life influenced your decision to attend graduate _ _ _ _ _ _ school _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Please sign and date your essay _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ EDUCATIONAL STATEMENT (Please read and sign) I understand that Boricua College reserves the right to refuse admission and matriculation to any applicant who, in the College’s judgment is not qualifies Boricua College reserves the right to require withdrawal of any student, at any time, for any reason deemed sufficient under the rules and traditional practices of the College _ Signature of Applicant _ Date of Application APPLICATION CHECKLIST Completed Application (The application cannot be processed if questions are left unanswered) M a 350 Word Personal Essay (Typed) n h A $100.00 non-refundable fee is required to process this application a (money orders only) t t College Degree (Bachelors) a n Official College Transcript (If foreign degree, must be translated by GLOBE or WES) C a Valid Government Issue ID m p Social Security Card and/or Alien Registration Card (If applicable) u s Admissions Interview B Proof of Income r o Immunization Record (Measles, Mumps and Rubella) n x Meningitis Response Form Completed C Resume and Cover Letter a m Please mail your application or drop it off in person to the location of your p choice: u Manhattan Campus Bronx Campus Center Brooklyn Campus Center s 3755 Broadway 890 Washington Avenue Graham Ave New York, NY 10032 C 212-694-1000 isanchez@boricuacollege.edu e n t e r Bronx, NY 10451 347-964-8600 brodriguez@boricuacollege.edu Brooklyn, NY 11206 718-963-4112 amorales@boricuacollege.edu Admissions Interview Interview Date _ / _ / _ Faculty Recommendation No Yes _ _ Faculty Signature: _ _ _ _ _ Results: _ _ _ _ English Oral High Medium Low _ _ _ _ _ _ _ Conceptual _ High _ Medium _ Low _ _ _ _ _ Affective _ Medium _ _Low _ _ High _ _ _ _ _ _ _ _ Clarity of Values High Medium Low _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Comments: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Recruiter: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _