For office use only
T/Y_____________________
D_____________________
N ondegree E nrollment A pplication
Please type or print legibly to minimize delays in processing your application and please make sure you answer all questions.
PERSONAL INFORMATION
1. Name __________________________________________________________________________
(last)
(first)
(middle initial)
2. Sex o Male o Female
3. Former last names, if any (e.g., maiden) __________________________________________________________________________
4. American University student number_____________________________________________________________________________
(used as your applicant ID)
5. Permanent address__________________________________________________________________________________________ (street)
(apartment number)
____________________________________________________________________________________________________________
(city)
(state)
(zip)
(country)
6. Preferred mailing address ____________________________________________________________________________________
(street)
(apartment number)
_____________________________________________________________________________________ (valid until____________)
(city)
(state)
(zip)
(country)
(date)
7. Telephone_________________________________________________ _______________________________________________
(permanent)
(current)
____________________________________________________________ _______________________________________________
(local work)
(e-mail address)
8. Date of birth ______/______/______
month
day
year
Answering question 9 is optional and will not affect your eligibility to enroll as a non-degree student.
9. Do you wish to identify yourself as a member of any of the following groups? o Yes o No
Are you of Hispanic/Latino Descent? o Yes o No
Please select any of the following that apply to your background:
o American Indian
o Black or African American o Pacific Islander (non-Native Hawaiian)
o Alaska Native
o Native Hawaiian o White
o Asian
10. Is English your first language? o Yes o No
11. Are you a U.S. citizen? o Yes o No
12. If no, state your country of citizenship __________________________________________________________________________
Questions 13 through 16 are to be answered by non-U.S. citizens only. AU cannot issue an F-1 or J-1 visa for non-degree study.
13. City and country of birth ____________________________________________________________________________________
14. Visa type _________________________________ 15. Are you a permanent U.S. resident? o Yes o No
16. What type of immigration status do you plan to hold while at AU?____________________________________________________
ENROLLMENT INFORMATION
17. Why are you interesting in taking nondegree courses?
o Job related reasons
o Degree candidate at another institution planning to transfer
earned credits (Current school:________________________________________________)
o Personal reasons
o Missed the application deadline o Plan to strengthen academic record before applying for admission
18. Have you applied for admission to American University before?
o Yes o No If yes, for what semester _____________________________________________ year ______________________
19. Have you ever enrolled at American University? o Yes o No If yes, please check the appropriate box(es)
o Undergraduate o Graduate o Nondegree o Certificate Program
For what semester __________________________________________________ year ______________________
20. Have you ever been dismissed from American University or another college or university in the past 12 months? o Yes o No
If yes, from which institution? ___________________________________________________________________
For what semester____________________________________________________year______________________
21. Work experience: Number of years of full–time work experience (if applicable) _______ (include résumé)
PREVIOUS UNDERGRADUATE AND GRADUATE STUDY
Please list chronologically every college, university, professional school, or other postsecondary institution at which you have studied. Attach additional sheets, if necessary. All institutions must be reported.
Undergraduate:
Name of College and Location Date Begun Date Ended
Degree Awarded and Major Date Awarded
CEEB Code
22. Undergraduate GPA for the last 60 hours_____________________________
Graduate:
Name of College and Location Date Begun Date Ended
Degree Awarded and Major Date Awarded
CEEB Code
23. Graduate GPA_________________________ number of credit hours _____________________
SIGNATURE
I hereby apply for admission to American University. If admitted, I agree to abide by its regulations. I certify that the foregoing
information is true and complete to the best of my knowledge and fully realize that omission or falsification of information will be
considered sufficient reason for rejection of this application or for dismissal.
_______________________________________________________________
(signature of applicant)
AMERICAN UNI V E R S I T Y S C H O O L O F P U B L I C A F F A I R S
_____________________________________
(date)