Graduate Degree Program Application
Biographical information
Last Name:
First Name:
Middle Name:
Maiden (or Prior) Name:
Email Address:
Stout Student I.D. # (if applicable)
Highest Degree Awarded:
___BA/BS
Institution Name:
or
____MA/MS
Social Security #
Year awarded:
GPA:
Standard scores: TOEFL (score/date taken):
(if taken)
GRE (score/date taken): Verbal =
Master’s degree title (if applicable):
Quant. =
Analyt.=
Program to which you are applying:
M.S.Ed School Psychology = (all applicants entering the program from undergraduate status)
Ed.S. School Psychology = (applicants with a Master’ degree in a related field may enter at the Ed.S. level)
M.S.Ed School Psychology w/ dual School Counseling certification (contact school psych. program director
before selecting this option)
Personal Statement /Autobiographical Sketch: Attach a statement (maximum of 3 typewritten, double spaced
pages) which describes your potential as a graduate student in the program you have chosen, as well as your motivation for
entering that program. The statement should clearly indicate your understanding of the roles and functions of professionals in the
degree program for which you are seeking admission. Your personal statement may also reference activities/employment in
which you have been involved that make you a particularly good candidate for admission to this program. Remember, your
personal statement is a very important part of your application. Proper use of grammar and correct spelling are expected. Please
note that you are only required to submit one personal statement. If you are prompted on the online graduate application to
provide a personal statement, you may reference the statement you have provided for this purpose (i.e., “Please refer to the
personal statement provided as part of the program application”).
Recommenders: Identify three (3) individuals from whom you have requested a letter of recommendation. It’s important
that these individuals be able to comment directly on your scholastic aptitude, including your ability to express yourself in writing
at the graduate level (e.g., choose a professor from your undergraduate or graduate program).
By including the names and contact information for recommenders you are waiving your right to review this information
once it becomes part of your admission file.
It is best to advise each recommender the deadline by which all materials, including their letter, are due.
Current Deadline:
January 15 (for Summer and Fall admission; no Spring admission)
Name of recommender
e-mail address
phone
1.
2.
3.
Recommendation Letters can be mailed directly from the recommender to the following address:
UW-Stout
Attn: Shanna Hoffman
240C Heritage Hall
Menomonie, WI 54751
Or emailed directly from the recommender to hoffmansha@uwstout.edu.
ALL MATERIALS MUST BE POSTMARKED BY THE JANUARY. 15th DEADLINE IN ORDER TO BE CONSIDERED.
** IMPORTANT NOTE: A Graduate School application, transcripts and an application fee are also required.
(Available at this link: http://www.uwstout.edu/grad/apply.html)
Rev. 12/13