CONTINUING EDUCATION TRACK:
ADMISSIONS APPLICATION
PERSONAL INFORMATION
Legal Name:
Last (Family)
First
Date of Birth:
Middle
Male
E-mail:
Suffix
Female
Telephone:
Begin with Area/Country Code
PERMANENT ADDRESS
Street Address
City/Town
State/Province
Country
Zip/Postal Code
CURRENT MAILING ADDRESS (if different from Permanent Address)
Current Mailing address valid until:
Date
Street Address
City/Town
State/Province
Country
Zip/Postal Code
CITIZENSHIP
Place of Birth:
City/Town
State/Province
Country
U.S. Citizen
Dual U.S. Citizen; please specify other country of citizenship:
U.S. permanent resident; citizen of:
Other citizenship:
If you have a visa, what type is it:
Do you identify as Indigenous?
Yes, I identify as:
No
List your primary language, if not English:
E-MAIL COMPLETED APPLICATION TO:
IGP@EMAIL.ARIZONA.EDU
ACADEMIC INFORMATION
Please attach unofficial transcripts from all post-secondary educational institutions to your application.
Please indicate the highest level of education completed:
High School Completed
Some College/University/Technical School
College/University/Technical School Completed
Some Graduate School (MA, MS, PhD, JD, MD, etc.)
Graduate School Completed (MA, MS, PhD, JD, MD, etc.)
Please indicate the school’s name where you completed your highest level of education:
If you have any information about your academic past that you wish to share with the admissions committee,
please do so here:
EMPLOYMENT INFORMATION
Please list any employment you’ve had over the past five years or attach a resume to your application:
Employer:
Job Description:
Dates of Employment:
ADDITIONAL INFORMATION
If you have any additional information you wish to share with the admissions committee, please do so here:
PERSONAL STATEMENT
Please write a brief (1-2 page) personal statement about why you want to learn more about Indigenous
governance and Indigenous rights and send it with your application.
E-MAIL COMPLETED APPLICATION TO:
IGP@EMAIL.ARIZONA.EDU
APPLICATION CHECKLIST
Before submitting your application, please make sure you have all necessary documents:
Completed Application Form (this document)
Transcripts (unofficial) from any post-secondary educational institutions
Resume, if you did not include employment information on this form
Personal Statement (1-2 pages)
Please e-mail all of these materials to igp@email.arizona.edu.
If you are unable to e-mail materials for some reason, then send your materials via postal mail to:
Attention: Indigenous Governance Programs
c/o Native Nations Institute
University of Arizona
803 East First Street
Tucson, Arizona 85719-4831
AUTHORIZATION
Your signature below confirms that all information in this application (including any supplemental
information) is factually true and honestly presented and that you are the person submitting this application.
Signature
Date
E-MAIL COMPLETED APPLICATION TO:
IGP@EMAIL.ARIZONA.EDU