Graduate Programs in Department of Technology
at
The University of Northern Iowa
Cedar Falls, Iowa 50614
APPLICATION FOR ADMISSION
DOCTOR OF INDUSTRIAL
TECHNOLOGY PROGRAM
(Please type or print in ink)
Name:
Last
First
Social Security Number:
-
Middle
Preferred Entering Date:
-
Fall Semester, August 20
Spring Semester, January 20
Summer Session, June 20
UNI Student Number:
Present Address:
City
State
Telephone Number: (
)
-
Zip
Country
Until What Date:
Permanent Address:
City
Telephone Number: (
State
)
-
Zip
Country
Email Address:
Are you interested in an assistantship?
Yes
No
If yes, have you attached the application for a graduate assistantship?
Yes
No
Graduate Record Examination is required for admission. Date you took the GRE:
Please list the three individuals you have asked to submit professional references in support of
your application for admission to the graduate program.
1.
2.
3.
Name
Name
Name
Position
Address
City
State
Position
Address
City
State
Position
Address
City
State
Zip
Zip
Zip
1/5
Graduate Programs in Department of Technology
at
The University of Northern Iowa
Cedar Falls, Iowa 50614
College & University Experience:
Please list, in reverse chronological order (most recent first), all colleges and universities
attended.
Dates Attended
Degree, if any,
School
Location
Major Subject
From
To
and Year Received
Professional Experience:
Please list, in reverse chronological order, employment (including summer work) or military
service since secondary school. Please include validation for the number of years of related and
significant work experience as required for the degree.
Dates
Employer
Position
Part or Full-time
From
To
P/T
F/T
P/T
F/T
P/T
F/T
P/T
F/T
P/T
F/T
P/T
F/T
Extracurricular/ Community Activities:
Please list, in order of importance to you, your major extracurricular and community activities
in college and since baccalaureate graduation.
Dates
Offices Held, Distinctions,
Activity
From
To
Awards, Etc.
--------------------------------------------------------------------------------------------------------------------Technology Issues, Career Goals, Special Qualifications:
The Graduate Admissions Committee will assess this ability and will use it as ONE source of
information in evaluating your application for admission. Some factors that will be used in
evaluating your responses are a) organization and content, b) writing style and mechanics, c)
expression of ideas, and d) congruency of rationale.
The Department of Technology Graduate Admissions Committee asks that you respond to the
following questions only in the space provided and in your own handwriting.
2/5
Graduate Programs in Department of Technology
at
The University of Northern Iowa
Cedar Falls, Iowa 50614
1. Describe what you perceive as a major issue or problem relative to the discipline of industrial
technology. Include your reasons for selecting the issue or problem.
3/5
Graduate Programs in Department of Technology
at
The University of Northern Iowa
Cedar Falls, Iowa 50614
2. What are your career goals in relationship to the field of industrial technology, and why do
you perceive the attainment of this graduate degree as appropriate to your career goals?
4/5
Graduate Programs in Department of Technology
at
The University of Northern Iowa
Cedar Falls, Iowa 50614
3. Explain what there is about your personality and unique knowledge and skills that lead you to
believe that you can complete a doctoral program successfully.
4. Describe your technical expertise which has been developed in your educational, laboratory,
and professional experiences. How do you envision furthering, expanding, and/or establishing
your technical expertise?
In addition to the above responses, you may wish to submit one or two representative items of
previously written materials that would provide the Graduate Admissions Committee with
evidence of your writing ability. These may include: a) journal or magazine articles, b) term
papers or reports from previous educational experiences, or c) technical reports, project
reports, or other materials produced in various occupational roles.
Supplementary materials which you supply will be returned to you as soon as a decision on
your application is completed.
All International students should return materials to: Linda Jernigan, University of Northern
Iowa, Admissions Office- GIL 0002, Cedar Falls, IA 50614-0018. All other applicants please
return this application and all other materials to: Laurie Russell, Record Analyst, UNI Admissions
Office, Gilchrist 002, Cedar Falls, IA 50614-0018.
Revised 4/30/13
5/5