Bemidji State University

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School of Graduate Studies
Bemidji State University, #48
1500 Birchmont Drive NE
Bemidji, MN 56601-2699
Bemidji State University
[email protected]
Phone: 1-218-755-2027
Toll Free: 1-888-386-8464
Fax: 1-218-755-2258
Disclaimer Notification
Please read the following before completing this application as it may affect your ability to apply.
Illegal Activities:
Arrests, charges, or convictions of criminal offenses may limit employment possibilities in specific careers and occupations and may
limit your ability to obtain federal, state, and other financial aid. We encourage you to investigate these possibilities before you seek
admission to this institution and/or before you select a program.
Social Security and Birth Date Information:
Many colleges/universities use social security numbers and dates of birth for student identification purposes on student records.
Providing your social security number or birth date is strictly voluntary. If you do not provide this information, your application
will still be processed. This data is requested for purposes of administration, program evaluation and consumer and alumni data.
Your number also may be used to create summary information about MnSCU programs through data matches with other state
agencies.
Willful Misrepresentation and/or Previous Financial Obligation:
The misrepresentation of application information constitutes sufficient cause for the cancellation of admission or registration. All items
must be completed and returned prior to registration. Applicants who are under suspension or financial obligation at a previous
institution are not eligible for special admission.
Additional Application Materials
A $20 non-refundable application fee will be assessed along with this application.
Official transcripts and Letters of Recommendation are to be sent directly to: BSU School of Graduate Studies #27, 1500
Birchmont Dr NE, Bemidji, MN 56601-2699
Please note: Students who have completed their undergraduate degree at BSU or any other institution in the Minnesota State
Colleges and Universities (MnSCU) system are not required to provide official transcripts. All other non-MnSCU graduates must
provide official transcripts.
The following may be required by the student’s particular program and sent to the School of Graduate Studies:
Letter of Intent
GRE Scores
Curriculum Vita/Résumé
Additional Letters of Recommendation
Copy of Teaching License (Current or Former)
The School of Graduate Studies will contact applicants via the email address they initially provide on the application concerning
additional items required to complete their file.
Contact Information
Questions about the Application Process:
BSU School of Graduate Studies #27, 1500 Birchmont Dr NE, Bemidji, MN 56601-2699; 218-755-2027; 888-386-8464;
([email protected])
Questions about Program or Course Information:
Please contact the Instructor of the course, Graduate Coordinator, or Chair of the Department.
PRINT AND KEEP THIS PAGE FOR YOUR RECORDS
4/26/12
Bemidji State University
School of Graduate Studies
Bemidji State University, #48
1500 Birchmont Drive NE
Bemidji, MN 56601-2699
[email protected]
Phone: 1-218-755-2027
Toll Free: 1-888-386-8464
Fax: 1-218-755-2258
Confidential Information
*Required Fields
Request for Confidential Information:
Providing the following information is voluntary. This information will assist Minnesota State Colleges and Universities (MnSCU)
system in evaluating student recruitment and retention policies; it will not be used as a basis for admission.
Name:
*Last
*First
MI
Maiden (Optional)
Gender:
Male
Female
Racial or Ethnic Background (select any that apply):
Hispanic or Latino - a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture regardless of
race
American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central
America) who maintains cultural identification through tribal affiliation or community attachment.
Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian subcontinent.
Black or African American - A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other
Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Please complete and submit along with Form 1-Application for Admission to Graduate Studies. Thank you.
Bemidji State University is an Equal Opportunity Educator and Employer
Scroll down for: Form 1- APPLICATION FOR ADMISSION TO GRADUATE STUDIES
4/26/12
Bemidji State University
School of Graduate Studies
Bemidji State University, #48
1500 Birchmont Drive NE
Bemidji, MN 56601-2699
[email protected]
Phone: 1-218-755-2027
Toll Free: 1-888-386-8464
Fax: 1-218-755-2258
FORM 1-APPLICATION FOR ADMISSION TO GRADUATE STUDIES
*Required Fields
BSU ID #:
Social Security #:
Birth Date:
Name:
*Last
*First
MI
*Permanent Address
*City
County
*Country
Maiden (Optional)
*State
*Zip Code
*Phone Number
Work/Cell Number
*Application Term:
Year:
*Email Address
*Graduate Program desired:
MA
MS
Applied Master’s
*Expected Area of Study:
Emphasis Area (required for MED/MS in Education only):
*Are you a resident of Minnesota?
Yes
No
*Length of Residency:
*If you are not a resident of Minnesota or have resided less than 12 months in Minnesota, what is your state of residence?:
*Are you a United States citizen or permanent resident?
Yes
No
If you are not a US citizen or permanent resident, please contact the International Program Center for application materials at
[email protected] If permanent resident, please provide copy of green card.
Have you previously attended BSU?
Yes
No
If “Yes,” last year of attendance:
*Bachelors degree received from:
*Date granted:
(official transcripts needed if NOT MnSCU graduate)
*Undergraduate Major(s):
Minor(s):
College(s) previously attended:
Master’s degree from:
Date granted:
*Have you had or do you have a current teaching license?
*If “Yes,” please specify:
MN Standard/Full-time
Yes
No
Limited/Restricted
Out-of-State
*I certify that the information I have provided on this application and in all other admission materials is complete, accurate, and true
to the best of my knowledge.
*Signature:
*Today’s Date:
Bemidji State University is an Equal Opportunity Educator and Employer
Please print the Confidential Information page and application, sign the application, and submit to the BSU School of Graduate
Studies, along with a check in the amount of $20 made payable to BSU.
School of Graduate Studies, Bemidji State University, #27, 1500 Birchmont Drive NE, Bemidji, MN 56601-2699
4/26/11
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