Office of Admissions
4400 University Drive, MS 3A4, Fairfax, Virginia 22030
Phone: 703-993-2400; Fax: 703-993-4622
Moscow State University / George Mason University Admission Application
Revised September 2009
Please type or print the information below and return this form with the required documents..
PERSONAL INFORMATION (Please Print name as it will appear on your passport.)
Name
__________________________________________________________________
Last/Family Name
Date of Birth
First
_____/_____/_____
Day
Permanent Address
Month
Gender
Middle
Male______ Female_____
Year
__________________________________________________
Street Address
Apartment No.
________________________________________________________________________
City/Locality
Phone
Postal Code
Country
_____________________________________________________________
Country Code
Please enter your foreign permanent phone umber in the space provided.
Email __________________________________________________________________
Major
Please check the box for your intended major
 Bachelor of Science in Economics
 Bachelor of Science in Management
ENROLLMENT HISTORY
Secondary School ______________________________________________________________
Name of School
Exam Score(s)
City
State/Province
Country
______________________________________________________________
Subject
Score
Date
______________________________________________________________
Subject
Score
Date
______________________________________________________________
Subject
Score
Date
______________________________________________________________
Subject
Score
Date
TEST INFORMATION
Test results should be sent to George Mason University’s Office of Admissions directly from your testing agency.
Have you taken the TOEFL or IELTS exam?
_____________________________________________
Test
Score
Date Taken
Yes / No
________________________________________________
Test
Score
Date Taken
INTERNATIONAL INFORMATION
Country of Citizenship ________________________ City and Country of Birth ___________________________
Native Language ___________________________ How long have you studied the English language? _____________
Have you visited the United States before?
If Yes, When ______________
Yes / No
For what purpose: __________________________________________
GENERAL INFORMATION
Have you ever been placed on academic or social suspension or dismissed from any college, university, or other formal
postsecondary educational program? (If yes, attach a statement of explanation.) Yes / No
HONOR CODE
George Mason University shares the tradition of an honor system that has existed in Virginia since 1842. The Honor Code is
an integral part of university life, and it is the student’s responsibility to understand the provisions of the code. Attempted
cheating, plagiarism, lying, and stealing constitute Honor Code violations. In the spirit of the code, students and faculty must
report all violations to the Honor Committee. The complete Honor Code is found in the University Catalog and will be fully
explained during orientation.
I will read and accept the responsibility of the Honor Code if I am approved for admission to George Mason University.
Signature ________________________________________________
Date ________________________
ESSAY
The Admissions Committee is interested in learning more about you. On a separate sheet of paper, please write at least 150 words about
yourself and why you would like to participate in this program. Please include your name on your essay.
SIGNATURE
I certify that all information given on this application is complete, true, and correct.
Signature ________________________________________________
Date ___________________________