Advanced Certificate in Taxation
Application
LUCAS GRADUATE SCHOOL
OF BUSINESS
NAME: ________________________________________________
Other name(s) that may appear on your academic records:
___________________________________________________________________________________
Program Director:
Annette Nellen
408-924-3508
annette.nellen@sjsu.edu
Address:
____________________________________
____________________________________
Birth Date:_________________________
Email Address:______________________
Work Phone:_______________________
Home Phone:_______________________
Institutions Attended:
School Name
Degree Awarded Date Awarded
Procedure:
 Complete this form
 Submit this completed form with copy of transcript to address shown on this form.
(Does not have to be official transcript)
Lucas Graduate School of Business
Business Tower, Room 350
One Washington Square
San Jose, CA 95192-0162
Voice: 408-924-3508
Fax: 408-924-3426
E-mail: annette.nellen@sjsu.edu
Submit only the transcript from the institution that holds the LLM or MST.
13