University of Pittsburgh Transfer Application Office Use Fee paid Fee W. Complete For Undergraduate Admission and Financial Aid Personal Data 1 Name of your records are under a name other than the 2 Ifoneanygiven above, please indicate 3 Occupation (if applicable) 4 Permanent Address Last Name First Middle Last Name First Position (Area Code) Telephone Number Student E-mail Address 5 Temporary Mailing Address Middle Employed by Street Social Security Number City StateZip (Area Code) Student Cell Phone Number Parent/Guardian E-mail Address Street (Area Code) Parent Cell Phone Number City StateZip (Area Code) Telephone Number Until what date? 6 of Mother/Guardian 7 Name (Circle one) of Spouse 8 Name (if married) Members 9 Family ¨Father Who Are Pitt Alumni ¨ U.S. Citizen 10 Student Citizenship ¨Refugee you a veteran of 11 Are the U.S. armed services? ¨Yes ¨No Name of Father/Guardian (Circle one) Last Name First Middle Initial Occupation Employed By Last Name First Middle Initial Occupation Employed By Last Name First Middle Initial Occupation Employed By ¨Mother ¨Sibling ¨Spouse ¨ U.S. Immigrant/Permanent Resident Alien ¨Non-immigrant (Please do not use this application.) ¨Grandparent you plan to use your own, parents’, or spouse’s military or veteran 12 Doeducational ¨Yes benefits to pay for your education at the University? ¨No Optional: Your responses to questions 13-15 are voluntary and will be kept confidential. Refusal to complete this information will not be used to deny access or admission. The information will, however, assist the University in providing data to demonstrate compliance with federal regulations. of 13 Date Birth Group: 15 Race/Ethnic Please respond to both of the following questions. a. MonthDay Year 14 Sex ¨Male ¨Female Are you of Hispanic or Latino ethnicity (meaning a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race)? ¨Yes ¨No b. Please select one or more race(s)/ethnicity(ies) from the following groups that you identify with: ¨ American Indian or Alaskan Native ¨ Black or African American ¨Asian ¨ Native Hawaiian or Other Pacific Islander for 16 Applying term beginning: ¨Fall (September) ¨Yes you previously applied to 18 Have the University of Pittsburgh? ¨No ¨Yes you ever enrolled at 19 Have the University of Pittsburgh? ¨No ¨Yes you currently attending 20 Are the University of Pittsburgh? ¨No ¨Spring (January) If so, what school/campus, term, and year? If so, what school/campus, term, and year? If so, what school/campus, term, and year? ¨Summer (May) ¨White 17 Year beginning: School/Campus TermYear School/Campus TermYear School/Campus TermYear Last Name First Middle in which you desire to enroll: 21 School (see next two pages) Intended field of study: (see next two pages) field of study: If you are considering 22 Supplemental earning a certificate, specify it here. in chronological order every high school and post-secondary school you have attended (and plan on continuing to attend), the city, state, and 23 List dates attended (attach an extra page, if needed). School City State From: MM/YY To: MM/YY School City State From: MM/YY To: MM/YY School City State From: MM/YY To: MM/YY School City State From: MM/YY To: MM/YY ¨Yes (see page 3) you desire 24 DoUniversity If no, check one: housing? ¨No 25 County of Residence: academic level 26 Atdo which you plan to enroll? ¨Freshman ¨Sophomore credit load 27 Expected (to be filled out by part-time students only) Fall term: enrollment. Please list all courses you are taking and/or 28 Current will take prior to your enrollment at the University of Pittsburgh. Current Courses Credit Hours ¨ ¨Junior Spring term: Off-campus resident ¨Senior ¨ Fifth year Summer term: Courses to Be Taken Total Credit Hours Credits completed to date: ¨ Commute from parents’ home Credit Hours Total Credit Hours Cumulative grade point average: 29 Check if you are interested in: ¨Debate ¨ Air Force ROTC ¨ Religious Interest or Affiliation: ¨Band (specify what instrument you play): ¨ Army ROTC ¨ Naval ROTC 30 Personal Essay (Required.) I understand this application will not be complete until I have submitted my final, official high school transcript upon graduation and, if I 31 Signature am a transfer applicant, all final, official post-secondary transcripts. I understand the University will prevent my registration and/or graduation from the University should these documents not be provided. Signature of applicant The University of Pittsburgh is an affirmative action, equal opportunity institution. Date University of Pittsburgh, Pittsburgh Campus Intended Field of Study (Question 21): Look over the list of possible fields of study, then write in the name of your intended field of study or pre-professional interest. Kenneth P. Dietrich School of Arts and Sciences Actuarial Mathematics Africana Studies Africana Studies—English Anthropology Architectural Studies Arts and Sciences/Business Dual Major Astronomy Bioinformatics Biological Sciences Chemistry Chinese Classics Communication Rhetoric and Communication Computer Science Ecology and Evolution (Biological Sciences) Economics Economics/Statistics English Literature English Writing Environmental Geology Environmental Studies Film Studies French Geology German History History and Philosophy of Science History of Art and Architecture Italian Language and Literature Italian Studies Japanese Linguistics Mathematical Biology Mathematics Mathematics, Applied Mathematics—Economics Microbiology (Biological Sciences) Molecular Biology (Biological Sciences) Music Neuroscience Philosophy Physics Physics and Astronomy Political Science Politics—Philosophy Psychology Religious Studies Russian Slavic Studies Sociology Spanish Statistics Studio Arts Theatre Arts Undecided Major Urban Studies Preprofessional Preparation in Arts and Sciences Below are sequences of required classes for professional or graduate schools, not majors. Pre-Administration of Justice Pre-Allied Health Careers (including preparation for graduate schools of chiropractic medicine, optometry, podiatry, veterinary medicine, etc.) Pre-Applied Developmental Psychology Pre-Athletic Training Pre-Clinical Dietetics and Nutrition Pre-Communication Science (speech pathology and audiology) Pre-Dentistry Pre-Education (pre-teacher certification, certification available at the fifth-year level only) Pre-Emergency Medicine Pre-Health and Physical Activity Pre-Health Information Management Pre-Information Sciences Pre-Law Pre-Legal Studies Pre-Medicine Pre-Occupational Therapy Pre-Pharmacy (for transfer applicants who need to complete prerequisite courses in the Dietrich School of Arts and Sciences) Pre-Physical Therapy Pre-Physician’s Assistant Pre-Public Service Pre-Rehabilitation Science Pre-Social Work College of Business Administration CBA—Undeclared Accounting Business Information Systems Finance Global Management Human Resources Management Marketing Supply Chain Management Swanson School of Engineering If you are enrolled in a 3/2 engineering program or a CCAC/ Pitt Transfer Articulation program, please note this at the top of your application for admission. Bioengineering Chemical Civil and Environmental Computer Electrical Engineering/Arts and Sciences Joint Degree Engineering Science Engineering, Undecided Industrial Materials Science & Engineering Mechanical College of General Studies Administration of Justice Dental Hygiene (degree completion) Health Services Humanities Legal Studies Media and Professional Communications Natural Sciences Pre-Education Pre-Health and Rehabilitation Sciences Pre-Information Sciences Pre-Pharmacy Pre-Social Work Public Service Self-designed Major Social Sciences Undeclared School of Nursing Nursing Upper-Level Division Schools and Supplemental Fields of Study: College of Business Administration Certificate Programs Upper-Level Division Schools Supplemental Fields of Study Students interested in the schools listed below transfer at the junior year level. Students with fewer credits begin their University studies in the Dietrich School of Arts and Sciences taking prerequisite courses (look under PreProfessional Preparation in Arts and Sciences for a list of intended fields of study). The following are certificate, not degree programs. A certificate is a concentration of study that can complement a major. If you think you may be interested in earning a certificate in one of the fields, below, please note it on Question 22. Note: your certificate typically needs to be in the same school as your major. School of Education Dietrich School of Arts and Sciences Certificate Programs Swanson School of Engineering Certificate Programs American Sign Language Arabic Language and Linguistics Children’s Literature Conceptual Foundations of Medicine Geographic Information Systems German Language Jewish Studies Medieval & Renaissance Studies Photonics Public and Professional Writing Women, Gender, and Sexuality Energy Resources Utilization Engineering for Humanity Health Systems Engineering International Engineering Studies Mining Engineering Nuclear Engineering Product Realization Sustainability Engineering Applied Developmental Psychology Applied Developmental Psychology—CASE Health and Physical Activity (Exercise Science, Wellness) School of Health & Rehabilitation Sciences Athletic Training Communication Science (Speech Pathology & Audiology) Emergency Medicine Health Information Management Nutrition and Dietetics Rehabilitation Science School of Information Sciences Information Sciences School of Pharmacy (Do not use this application, See page 5) Pharmacy School of Social Work University Center for International Studies Certificate Programs African Studies Asian Studies European Union Studies Global Studies Latin American Studies Russian and East European Studies West European Studies Social Work International Business Leadership and Ethics Supply Chain Management College of General Studies Certificate Programs Accounting Communication Community Health Assessment Corporate/Community Relations Digital Media Information System Design Leadership Managing Health Services Programs National Preparedness and Homeland Security Nonprofit Management Women’s Studies Writing for the Professions The University of Pittsburgh, as an educational institution and as an employer, values equality of opportunity, human dignity, and racial/ethnic and cultural diversity. Accordingly, as fully explained in Policy 07-01-03, the University prohibits and will not engage in discrimination or harassment on the basis of race, color, religion, national origin, ancestry, sex, age, marital status, familial status, sexual orientation, gender identity and expression, genetic information, disability, or status as a veteran. The University also prohibits and will not engage in retaliation against any person who makes a claim of discrimination or harassment or who provides information in such an investigation. Further, the University will continue to take affirmative steps to support and advance these values consistent with the University’s mission. This policy applies to admissions, employment, access to and treatment in University programs and activities. This is a commitment made by the University and is in accordance with federal, state, and/or local laws and regulations. For information on University equal opportunity and affirmative action programs, please contact: University of Pittsburgh, Office of Affirmative Action, Diversity and Inclusion, Carol W. Mohamed, Director (and Title IX, 504 and ADA Coordinator), 412 Bellefield Hall, Pittsburgh, PA 15260 (412) 648-7860. For complete details on the University’s Nondiscrimination Policy, please refer to Policy 07-01-03. For information on how to file a complaint under this Policy, please refer to Procedure 07-01-03. SAFETY AND SECURITY BROCHURE As mandated by federal and state law, the University of Pittsburgh has published a brochure that describes safety and security policies, procedures, and programs, as well as campus crime statistics for the past three years. If you would like a copy, please write to the address at right: University of Pittsburgh Mailing Services Campus Safety Information 400 N. Lexington Avenue Pittsburgh, PA 15260 Or, you can check the University of Pittsburgh’s most recent For Safety’s Sake information online at: www.safety.pitt.edu