Admission Application for the
Post-Baccalaureate Certificate Program
Western Illinois University
School of Graduate Studies
Note: This form is to be used by current WIU graduate students only. If you have not applied to the Graduate School, you must apply by completing
an Admission Application.
I would like to apply for a post-baccalaureate certificate program at Western Illinois University.
Name:
WIU ID No.:
Current address:
Email address:
Phone number:
Please indicate post-baccalaureate certificate program(s):
___ Business Analytics
___ Instruct. Design & Tech. - Tech. Integration in Ed.
___ Community Development and Planning
___ Instruct. Design & Tech. – Workplace Learning & Perform.
___ GIS Analysis: Ecological GIS
___ Museum Studies
___ GIS Analysis: GIS Applications
___ Music Performance
___ Health Services Administration
___ Police Executive Administration
___ Instruct. Design & Tech. - Ed. Technology Specialist
___ Supply Chain Management
___ Instruct. Design & Tech. - Instructional Media Dev.
___ TESOL
___ Instruct. Design & Tech. - Online & Distance Learning
___ Zoo and Aquarium Studies
Semester to begin program:
Student’s signature _____________________________________________________
Date: _____________________
Complete and return to the School of Graduate Studies.
Upon completion of all post-baccalaureate certificate requirements the student must submit a Post-Baccalaureate Certificate Completion
Application form to the School of Graduate Studies by March 10 (spring semester), June 10 (summer session), or October 10 (fall semester).
Western Illinois University
School of Graduate Studies
1 University Circle
Macomb, IL USA 61455-1390
Phone (309)298-1806; Fax (309)298-2345
wiu.edu/grad; Email: Grad-Office@wiu.edu
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