GRADUATE APPLICATION ADDENDUM
Name _________________________________________
CSU ID _____________
Please check all that apply.
I am still interested in pursuing my educational goals at Cleveland State University!
I would like to defer my graduate program admission to:
Summer Semester 2013
Fall Semester 2013
Spring Semester 2014
I will have lived continuously in the State of Ohio for the 12 months that immediately
precede my first day of enrollment at Cleveland State University.
I graduated from another college or university since I originally applied for admission to
Cleveland State.
College or
University: _______________________________________Graduation: _________________
I attended or have been attending another college or university since I originally applied for
admission to Cleveland State.
College/
University: ___________________________________________________________________
Dates of
Semester
Attendance: __________________ to __________________Credits Earned: ______________
My address has changed.
Street
Address: ____________________________________________________________________
City: ________________________________ State: ___________ ZIP Code: _____________
My educational plans have changed, and I am no longer interested in Cleveland State University.
I certify that the information provided on this application addendum is complete and accurate. I understand that any misrepresentation or omission is cause
for denial or cancellation of admission. I also understand that courses completed at another college or university will not be considered for transfer credit,
regardless of circumstance, unless acknowledged on the original application or this application addendum.
Signature: ________________________________________________________ Date: _______________


Fax this completed Graduate Application Addendum to 216-687-5449
5400 or
Mail it to:
Cleveland State University
Graduate Admissions Processing
2121 Euclid Avenue MC116
KB 1400
Cleveland, OH 44115-2214
01/2013
Rev 11/19/2013