APPLICATION FOR GRADUATE STUDY






*Please note that program-specific applications are required for Master of Business Administration, Master of Divinity, Family Ministry,
Family Psychology, Nursing, and Physical Therapy. See http://www.hsutx.edu/academics/graduate/application/ to download other program forms.

GENERAL INFORMATION

Last Name: First:

Middle:
 
Preferred Name: Maiden:

Previous married name:

Social Security Number:

Date of Birth: Month Day Year

Local Address : City: State: Zip:

Home Phone: Work Phone: (include area code)
E-Mail Address: (include valid email address)

Permanent Address : City: State: Zip:

Home Phone: (include area code)

Country of Residence: Country in which you were born:

Ethnicity

Are you a US citizen? Yes No

If No, what is your citizenship?

GRE EXAMINATION

Have you taken the GRE? Yes No

If yes, when? Month Day Year

If not, do you intend to do so? Yes No

If yes, when? Month Day Year
 
 
Name of School Location Degree Earned
LIST ALL COLLEGES/UNIVERSITIES ATTENDED

Dates of Attendance:
 From To
Name of School Location Degree Earned
Dates of Attendance:
 From To
Name of School Location Degree Earned
Dates of Attendance:
 From To

*Important Note: Official transcript copies (sent directly to the Office of Graduate Studies) from all schools attended are required for admission
to graduate study.

DO YOU WISH TO...(indicate all that apply)

Pursue a Graduate Degree ? Yes No

Field of Study

Take Graduate Courses for Certification? Yes No

Type of Certification

When do you plan to begin? Semester Year

TEACHER CERTIFICATION

Do you hold a valid teacher certificate? Yes No

If yes, from which state?

Are you seeking initial teacher certification? Yes No

Are you seeking additional teacher certification? Yes No

If yes, select the appropriate program.




FOR INTERNATIONAL STUDENTS ONLY

Have you taken the TOEFL? Yes No

If yes, when? Month Day Year

If not, do you intend to do so? Yes No

If yes, when? Month Day Year

Have you requested that your test scores be sent to HSU? Yes No

If yes, when? Month Day Year


*Please review all your entries before submitting this form!*

Before submitting, you must certify that the information provided on this application is true. You must understand that providing false information may result in denial of your application for admissions or in dismissal from enrollment in graduate studies at Hardin-Simmons University.


Click here to send your information.

Click here to clear the form.


2200 Hickory, HSU Box 16210
Abilene, TX 79698-6210
325.670.1298
888.478.1222
gradoff@hsutx.edu