Mail Request for an MSW Application Packet for
Admission into the MSW Program in Fall Quarter 2016
Please print, fill out, and return this form to our office along with a $10 check or money order payable
to: “CSUSB”.
Name
Mailing Address
Apt. #
City
Phone
State
Email
Return to:
SCHOOL OF SOCIAL WORK – MSW PROGRAM
CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO
5500 UNIVERSITY PARKWAY
SAN BERNARDINO, CA 92407
FOR OFFICE USE ONLY
Check/MO #
Appl. Pkt. #
Date Mailed
Mail Order #
Rev. 6/15
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Zip