Graduate Studies Office 206 Showalter Hall • Cheney, WA 99004-2444 • (voice) 509.359.6297 • (fax) 509.359.6044 • www.ewu.edu/grad Eastern Washington University is committed to equal opportunity and affirmative action in employment. GRADUATE NON-MATRICULATED APPLICATION 1. Term for which you are applying: Fall Winter 2. Have you ever attended EWU before? Yes No 3. EWU ID (if known): ___________________________ Spring Summer Year: 20_________ If yes, last term attended: ___________ PERSONAL DATA 4. Legal name (Last, First Middle): 5. Former names: 7. Social Security number: 8. Date of birth: 6. Gender: Male Female 9. E-mail address: Please see disclosure statement on the following page. 10. Current mailing address, city, state and ZIP: 10a. County: 10b. Contact telephone: 11. Permanent mailing address (if different from above): 11a. Work telephone: 11c. Alternate telephone: 12. Are you a resident of Washington? Yes No 14. Are you a United States citizen? Yes No If no, country of citizenship: __________________________ 12a. If yes, on what date did you begin living in Washington? 13. Are you a military veteran? 14b. If no, are you a US permanent resident? No Yes; permanent residency card number: 14c. If you answered no to both 14a and 14b, please submit a Supplemental International Application. Yes No __________________________ ETHNIC INFORMATION (OPTIONAL) 15. Optional: How do you describe yourself? White (WN) Black/African American (BN) American Indian (Print the name of your enrolled or principal tribe): _______________________ (IN) Eskimo (EN) Aleut (DN) Asian or Pacific Islander (API): Chinese (CN) Filipino (FN) Japanese (JN) Korean (KN) Asian Indian (AN) Vietnamese (VN) Hawaiian (HN) Samoan (SN) Other API (Please indicate one group): ____________________________ Other ethnic background (print) ____________________________ 16. Optional: Are you or are you not of Spanish/Hispanic origin (check one)? No, not Spanish/Hispanic Yes, Puerto Rican (H2) Yes, Mexican, Mexican American or Chicano (H1) Yes, Cuban (H3) Yes, other Spanish/Hispanic (Please indicate one group): ____________________________ EDUCATIONAL BACKGROUND 17. List all colleges or universities in order of attendance, most recent first. Institution City and state Start date End date Degree earned Major 7-31-07 PROGRAM INFORMATION Students who have earned a bachelor’s degree or higher from an accredited institution may apply for non-degree-seeking (non-matriculated) graduate enrollment. The requirements for enrollment are as follows: Submit a graduate non-matriculated application to the Graduate Studies Office with the non-refundable fee. Provide an unofficial or official transcript showing at least a bachelor’s degree from an accredited institution. Please note the following: Enrollment is restricted to 500-level courses or below, subject to both program and instructor approval. Enrollment is subject to any course or program prerequisites. Non-matriculated students are eligible to enroll for up to one year (renewable) and are not eligible for financial aid. Non-degree-seeking graduate students pay graduate tuition. Non-matriculated status is not available to anyone holding an F-1 visa, nor will non-degree-seeking international applicants be issued an I-20. Non-degree-seeking graduate status is intended for students who do not wish to pursue a graduate degree or certificate; it is not to be used for provisional enrollment by those seeking regular admission to graduate studies. Students may apply at any time for regular graduate admission by completing the graduate admission application, submitting complete credentials and meeting any program-specific application requirements. The policies allowing a maximum of 12 pre-admission credits to be used in a graduate program and a maximum of six years to complete a graduate degree apply to any credits earned before formal admission to a graduate degree program. Enrollment as a graduate nonmatriculated student does not guarantee subsequent admission to graduate studies. Anyone seeking undergraduate nondegree enrollment must apply separately through the EWU Admissions Office. ADDITIONAL ITEMS TO BE SUBMITTED WITH THIS APPLICATION 18. Please include the following items with your application. Item Description Enclosed Fee $29.00 non-refundable application fee Official transcripts One official transcript from each institution Signed registration form A copy of your completed registration form with appropriate signatures Requested ACKNOWLEDGEMENT AND SIGNATURE 19. Have you ever been required to register as a sex offender by any legal authority within the US? Yes No 20. I certify that to the best of my knowledge, all statements I have made in this application are complete and true. I understand that any falsification of information or failure to submit two complete transcripts from all colleges and universities I have attended may result in the denial of this application or my subsequent dismissal from EWU. Signature: ______________________________________________ Date: ___________________________ DEPARTMENT APPROVAL 21. Signature: ______________________________________________ Date: ___________________________ DISCLOSURE STATEMENT Eastern Washington University complies with laws prohibiting the use of Social Security numbers (SSN) as the primary student ID. However, a SSN is required for financial aid, student employment and tax reporting to the IRS. Students’ records and information are handled in accordance with applicable state and federal laws. 7-31-07