Application Form DBA
All application materials are due by Feb. 1 of entry year.
Please type or print all information.
Last name
First
Middle
Mailing address, street
City
State
Phone (home)
Phone (mobile)
Phone (work)
Phone (other)
Email (home)
Email (work)
Email (other)
FAX
Citizenship:
q U.S. citizen q Other
ZIP
Resident status if non-U.S. citizen____________________________________________________
Proposed major field in the doctoral program:
q Accounting q Finance q Management q Marketing
The information requested below is optional and is used for institutional statistical research only.
This information is not a criterion for acceptance.
Gender:
q Male
Marital status:
q Female
Date of birth
Age
q Married q Single q Widowed q Divorced
Ethnic origin:
q African-American
q Asian-American
q Caucasian-American
q Hispanic-American
q Native-American
q Foreign-born (Other)
Religious or denomination preference:
A $50 fee is required from all new applicants for admission to Anderson University.
Anderson University Falls School of Business
DBA Program
Educational background (list chronologically all colleges, universities, and technical schools attended):
Name of Institution
Location
Date of attendance
Degree
Note: Request that official transcripts from all institutions listed above be sent to the Falls School of Business DBA Program.
Work experience (beginning with your current position, list all work experiences):
Name and location of employer
Position
Date
Academic honors, honorary organizations, student organizations, and major academic achievements:
List positions held in teaching, business, armed forces, or similar occupations (summer and full time). Briefly describe your
responsibilities in each job:
Anderson University Falls School of Business
DBA Program
Graduate Management Admissions Test: If you have taken this test, please indicate your scores and arrange to have a copy of
your official results sent to the address given on the back of this application.
Date taken (or to be taken) _______________________
_______ Quant
______ Verbal
______ Total
If you have not taken the test, please make arrangements to do so. You may get information by logging onto
www.gmat.org. Applications will not be processed unless scores are provided from a testing date within the last five years.
__________________________________________________________________________________________
References: Please list the names and positions of three individuals well acquainted with your previous work and academic ability.
Applicants are responsible for arranging to have each reference complete the reference form or send a letter of reference to the DBA
program director. If you are currently employed, one of these should be from your supervisor (chair or dean if you are currently on the
faculty of an educational institution).
Name
Title
Address
Phone (home)
Name
Phone (mobile)
Title
Address
Phone (home)
Name
Phone (mobile)
Title
Address
Phone (home)
Phone (mobile)
Anderson University Falls School of Business
DBA Program
Please answer the following two questions on separate sheets of paper and attach to your application.
1. Discuss experiences you have had that are relevant to your decision to pursue a graduate business degree. Describe the type of
professional work and intellectual goals for which you are preparing and how the DBA program at Anderson University
relates to your career objectives. In addition to the depth of study in a person’s discipline, the AU DBA program strongly emphasizes
both specific preparation for successful classroom teaching and the intentional integration of a Christian worldview into
the teaching of the discipline. Please describe why these are important to you and what you hope to gain through this program
in these areas.
2. The admissions committee would like to know as much as possible about each applicant. If there is other personal or professional information about yourself that you feel would assist the committee in making a more informed decisions, please
feel free to submit it along with this application. Please indicate any special strengths, concerns, or weaknesses you would like
the committee to consider.
________________________________________________________________________________________________________________________
To the best of my knowledge, the information on this application is true and accurate.
SignatureDate
Mail all materials to:
DBA Program Director
Falls School of Business
Anderson University
1303 E. Fifth St.
Anderson, IN 46012-3468
2/2013
Anderson University Falls School of Business
DBA Program