ONLINE REGISTRAR’S OFFICE
550 West Van Buren, 7th Floor
Chicago, IL 60607
Tel: 312.777.6333
ADMISSIONS DEPARTMENT
6301 Kaplan University Avenue
Fort Lauderdale, FL 33309
Tel: 866.527.5268 (Toll Free)
Tel: 954.515.4700
Online Programs Enrollment Agreement—Graduate Programs
This entire form must be completed and submitted as part of your Kaplan University record and should be faxed to your Admissions Advisor’s e-fax
number. Please print legibly.
Personal Information
NAME: ___________________________________________________________ PREVIOUS NAMES (if applicable): ________________________________
STREET ADDRESS: _______________________________________________________________________________________________________________
CITY: _____________________________________________________________ STATE: ________________________________ ZIP: ______________________
SOCIAL SECURITY #: _______________________________________________ ARE YOU A VETERAN? [ ] YES
[ ] NO
HOME TELEPHONE: ________________________________________________ WORK TELEPHONE: _______________________________________________
CELL PHONE: ______________________________________________________ FAX NUMBER: ________________________________________________
___
EMAIL ADDRESS 1: _________________________________________________ EMAIL ADDRESS 2: _____________________________________________
_
KAPLAN EMPLOYEE? [ ] YES [ ] NO DIVISION OF KAPLAN _____________________ WORK LOCATION: __________________________________________
EXPECTED START DATE: _______________________
Postsecondary Education
LAST EDUCATIONAL INSTITUTION: ____________________________________ DATES ATTENDED: _____________________________________________
MAJOR OR SPECIALIZATION: ___________________________________________ DEGREE OBTAINED: ___________________________________________
CITY: ___________________________________________________________
_____ STATE: ________________________ ZIP: ___________________________
EDUCATIONAL INSTITUTION: _________________________________________
__ DATES ATTENDED: ____________________________________________
MAJOR OR SPECIALIZATION: ___________________________________________ DEGREE OBTAINED: ___________________________________________
CITY: ___________________________________________________________
_____ STATE: ________________________ ZIP: ___________________________
EDUCATIONAL INSTITUTION: _________________________________________
__ DATES ATTENDED: ____________________________________________
MAJOR OR SPECIALIZATION: ___________________________________________ DEGREE OBTAINED: ___________________________________________
CITY: ___________________________________________________________
_____ STATE: ________________________ ZIP: ___________________________
YOUR LAST NAME AT THE TIME YOU COMPLETED YOUR UNDERGRADUATE DEGREE IF DIFFERENT FROM ABOVE: ____________________________
_____
Programs
Please indicate your program and emphasis area or specialization:
Master of Arts in Teaching and Learning
Emphasis Area
___ Teaching Literacy and Language: Grades K–6
___ Teaching Literacy and Language: Grades 6–12
___ Teaching Mathematics: Grades K–5
___ Teaching Mathematics: Grades 6–8
___ Teaching Mathematics: Grades 9–12
___ Teaching Science: Grades K–6
___ Teaching Science: Grades 6–12
___ Teaching Students With Special Needs
___ Teaching With Technology
Master of Education
Content Area (Grades 7–12)
___ English Language Arts
___ Mathematics
___ Science
___ Social Studies
___ Foreign Language
___ Visual & Performing Arts
QEC-084 (Revised 10/06)
Master of Business Administration
Specialization*
___ Entrepreneurship
___ Finance
___ Human Resources Management
___ Information Technology
___ Management, Communication, and Quality
___ Marketing
Master of Science in Criminal Justice
Specialization*
___ Corrections
___ Global Issues in Criminal Justice
___ Law
___ Leadership/Executive Management
___ Policing
*If not indicated, to be determined by the end of the second term.
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Initials
Financial
A minimum deposit of $95.00 is required at the time of enrollment to secure your place in class. If you begin classes, the deposit will be credited to your
first quarter’s tuition. The deposit is refundable for first-term students only if cancellation of enrollment is received by the University seven days prior to the
start of the term. If eligible, the refund will be processed within 30 days upon receipt of the cancellation notice. All students are required to pay a
$______ technology fee per term. The current tuition for your program will be $______ per credit hour. The tuition per credit hour is subject to change.
Tuition and fees are subject to change with 30 days of notice.
If applicable, your payment schedule is itemized on the Educational Installment Contract.
Textbooks
Students are responsible for purchasing textbooks and required course materials.
Proof of Bachelor’s Degree
Note to Students: In order to attend a graduate program at Kaplan University, students must have earned a baccalaureate degree from a college or university accredited by a regional or national accrediting agency recognized by the U.S. Department of Education, and attest to that fact. In signing this
Enrollment Agreement, you certify that you have graduated from such an institution. You will be required to provide official transcripts from this institution by the last calendar day of your first term (second term for MBA). If your official transcript is not received by Kaplan University by this date, you
will not be allowed to start the second term (third term for MBA) and all Title IV financial aid must be refunded to the appropriate source. You will
then be responsible for payment of these funds to Kaplan University. If, for any reason, this attestation is found to be false or untrue, you will be subject
to immediate dismissal from Kaplan University. Furthermore, all Title IV financial aid or any state or institutional funding must be refunded to the
appropriate source, and you will be responsible for payment of these funds to the original source or to Kaplan University.
Refund Policy
Applicants not accepted by the University shall be entitled to a refund of all monies paid.
CANCELLATION OF ENROLLMENT AGREEMENT: You may cancel your Enrollment Agreement without any penalty or obligation if requested in
writing and delivered to the University management within three business days after signing the Agreement, excluding Saturday, Sunday, and federal and
state holidays.
NOTICE TO STUDENTS: If you withdraw from the University up through the 60 percent point in any payment period and received federal financial
aid in the form of grant or loan funds, federal law requires that the University, and in some cases, you, the student, return funds you did not earn to the
U.S. Department of Education. The amount of federal financial aid that you have earned is computed by (1) determining the percentage of the payment
period for which federal financial aid was awarded and completed, and (2) multiplying such percentage by the total amount of federal financial aid that
was, or could have been, disbursed on your behalf for the payment period as of the date you withdrew. After the 60 percent point in the payment period,
you will have earned 100 percent of the federal financial aid funds already disbursed to you. This calculation concerning federal financial aid is separate
and distinct from the institutional refund policy and may result in your owing additional funds to the University to cover tuition charges previously paid
by federal financial aid prior to your withdrawal. If you plan to withdraw from the University, please contact your financial aid or business office to
determine the amount of funds, if any, that must be returned on your behalf.
WITHDRAWAL AFTER COMMENCEMENT OF CLASSES: The effective withdrawal date for a student shall be when any of the following occur:
1. The date the student notifies the University of withdrawal or the date of withdrawal, whichever is earlier,
2. The beginning date of any term in which a student fails to start classes,
3. The first business day following any 21 consecutive calendar days of absences (excluding scheduled breaks),
4. The date when the University terminates the student’s enrollment, or
5. The date that the student is scheduled to return from a leave of absence and fails to do so.
All refunds due will be made within 30 days of the student’s effective withdrawal date. The last date of actual participation (login) is used in calculating
any refund amount. Students who are continuing or restarting their enrollment at the University are subject to the Kaplan University Refund Policy.
Under this policy, the percentages of refundable charges are as follows:
Students Withdrawing
Refund
Prior to the first day of the term
During the first 6 calendar days of the first term (first-time students only)
During the first day through 10% of the term
After more than 10% and through 25% of the term
After more than 25% and through 50% of the term
After more than 50% and through 100% of the term
100% Tuition
100% Tuition
90% Tuition*
50% Tuition*
25% Tuition*
0% Tuition
*Less $100 Administrative Fee.
The University reserves the right to postpone or change the date or time when any class is offered.
In case of prolonged illness, accident, death in the family, or other circumstances that make it impractical to complete the program, a refund that is reasonable and fair to both parties shall be made.
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QEC-084 (Revised 10/06)
Initials
Additional Conditions
1. The University will not deny admission because of race, color, religion, ancestry, national origin, age, nondisqualifying disability, gender, sexual
orientation, marital status, or veteran status.
2. This agreement, its addenda, and its attachments constitute the complete agreement between the University and the student, and no verbal
statements or promises will be recognized or enforced.
3. The University does not imply, promise, or guarantee transferability of earned credits to any other institution.
4. The University has the right, at its discretion, to make reasonable changes in program content, materials, schedules, sequence of courses in programs,
or locations in the interest of improving the student’s education, or where deemed necessary due to industry changes, academic scheduling, or professional requirements. The University is required to make changes in programs or policies when ongoing federal, state, or accrediting changes affect students currently in attendance.
5. The University does not provide health services for students.
For Arizona Residents: Any questions or concerns about this school that have not been satisfactorily answered or resolved by the school should be directed to the
Arizona State Board for Private Postsecondary Education, 1400 West Washington Street, Room 260, Phoenix, AZ 85007, Tel: 602.542.5709, Website:
http://azppse.state.az.us.
Signatures
Any controversy or claim arising out of, or relating to, this agreement, or breach thereof, no matter how pleaded or styled, shall be settled by arbitration
in accordance with the Commercial Rules of the American Arbitration Association, and judgment upon the award rendered by the arbitrator(s) may be
entered in any court having jurisdiction.
My signature below certifies that I have read the three pages of this Enrollment Agreement and understand and agree to my rights and responsibilities,
and that the University’s cancellation and refund policies have been clearly explained to me. I understand that this agreement is a legally binding
agreement, and with my signature certify that I have received and read an exact copy of this agreement and the University Catalog. I further acknowledge that no oral statements have been made to me contrary to what is contained in this Enrollment Agreement.
Signature of Applicant _X
__________________________________________________________________________ Date _X
________________________
X
_________
(Please Initial)
X
_________
BUYER’S ACKNOWLEDGEMENTS:
(Please Initial)
X
_________
(Please Initial)
I acknowledge and understand that I will be held responsible for
the terms and conditions therein.
A copy of this enrollment agreement may be obtained from my
Admissions Advisor.
An electronic copy of the University Catalog is available at
www.kaplan.edu/ku/downloads.
As an authorized official of Kaplan University’s Admissions Department, I have interviewed the applicant and certify that, according to my judgment, the
applicant does meet the admissions requirements and standards of the University, and I recommend acceptance as a student. I further state that I have
made no verbal statements or promises to the applicant contrary to the terms set forth in this Agreement.
Kaplan University Authorized Representative
_X
_
Date _X
____________________________
Signature ________________________________________
Name (Please Print) _X
__________________________________________________________________
QEC-084 (Revised 10/06)
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ONLINE REGISTRAR’S OFFICE
550 West Van Buren, 7th Floor
Chicago, IL 60607
Tel: 312.777.6333
ADMISSIONS DEPARTMENT
6301 Kaplan University Avenue
Fort Lauderdale, FL 33309
Tel: 866.527.5268 (Toll Free)
Tel: 954.515.4700
Master of Arts in Teaching and Learning Attestation
This form must be completed and submitted as part of your Kaplan University record and should be faxed to your Admissions Advisor’s e-fax
number. Please print legibly.
Please note: In order to attend Kaplan University, all students must acknowledge, adhere, and attest to the following admissions requirements, policies, and disclosures. The following form should be completed, signed, and faxed to your Admissions Advisor’s e-fax number. This form must be
completed and submitted as part of your Kaplan University record.
I, _______________________________________________, have applied for admission as a Graduate School of Education student at Kaplan University.
(NAME)
I understand that one of the requirements for admission to Kaplan University is that I have earned a bachelor’s degree from a college or university
accredited by a regional or national accrediting agency as recognized by the U.S. Department of Education or that I will have earned a bachelor’s
degree from a college or university accredited by a regional or national accrediting agency as recognized by the U.S. Department of Education prior
to the start date of the term I am applying for.
I understand that even if I attest to having the required bachelor’s degree from a college or university accredited by a regional or national accrediting
agency as recognized by the U.S. Department of Education, Kaplan University must still receive my official transcripts by the last calendar day of my
first term. I understand that if my official transcript is not received by Kaplan University by this date, I will not be allowed to start the second term. I
understand that all Title IV financial aid must be refunded to the appropriate source, and that I will be responsible for paying all amounts owed to
Kaplan University directly. I understand that Kaplan University requires that applicants have achieved a minimum GPA of 2.5 on baccalaureate
coursework. Candidates who do not meet this requirement may submit an official transcript indicating a minimum CGPA of 3.0 from a master’s
degree or higher or from at least three graduate courses taken at a regionally or nationally accredited university to be used in lieu of the minimum
bachelor's degree CGPA required for admission.
I understand that if my transcripts show that I do not possess the required bachelor’s degree from a college or university accredited by a regional or
national accrediting agency as recognized by the U.S. Department of Education including the required 2.5 GPA on my baccalaureate coursework, any and
all financial aid that was disbursed on my behalf must be refunded to the appropriate source, and I will be responsible for payment of these funds to the
original source or to Kaplan University.
Students who completed their university education abroad must have earned an equivalent recognized baccalaureate degree. Students must request a
course-by-course translation and evaluation by one of the approved agencies listed by the National Association of Credential Services at the following
website: www.naces.org/members.htm. Official evaluated transcripts of international programs must be received by Kaplan University prior to enrolling
in the program. Foreign applicants who possess a bachelor’s degree from an institution in which English was not the primary language must submit
official TOEFL scores of at least 550 (paper format) or 213 (online format). The Dean has final discretion to approve candidates into a program.
The Master of Arts in Teaching and Learning program is primarily designed for K–12 educators. All activities within the courses are job-embedded
or relate to real-world experiences in the classroom. Specific modifications will be made to the courses to include alternative job-embedded activities
for non-practicing educators. Since the program is primarily designed for practicing teachers, the Dean may limit the emphasis area choices available
to non-practicing educators.
The Master of Arts in Teaching and Learning program and curriculum have been designed to provide students with the knowledge and practical
experience that meet nationally recognized standards for such a degree. However, individual state or school system requirements vary and may change
from time to time. Thus, Kaplan University makes no representations or warranties as to whether the degree program meets the specific requirements
for any individual state or school system for certification or pay increase purposes. Kaplan University suggests, and encourages, its students to independently research the requirements in any state and school system in which they intend to seek certification or a pay increase.
If, for any reason, this attestation is found to be false or untrue, I understand that I will be subject to immediate dismissal from the University, all
credits I have earned will be invalidated, and the University will take all other appropriate actions.
Furthermore, I understand that if this attestation is found to be false or untrue, all Title IV financial aid or any state or institutional financial aid
that was disbursed on my behalf must be refunded to the appropriate source, and that I will be responsible for payment of these funds to the original source or to Kaplan University, if the University is required to and has refunded such funds on my behalf.
By signing my name below, I attest that the information I have provided is true and correct to the best of my knowledge, and I understand all penalties and consequences that I could encounter.
Signature _X
____________________________________________________________________ Date _X
_______________________________________
QEC-084 (Revised 07/07)
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ONLINE REGISTRAR’S OFFICE
550 West Van Buren, 7th Floor
Chicago, IL 60607
Tel: 312.777.6333
ADMISSIONS DEPARTMENT
6301 Kaplan University Avenue
Fort Lauderdale, FL 33309
Tel: 866.527.5268 (Toll Free)
Tel: 954.515.4700
Master of Business Administration Program Attestation
Please note: In order to attend Kaplan University, all Master of Business Administration (MBA) program students must acknowledge, attest to, and
adhere to the following admissions requirements, policies, and disclosures. The following form should be completed, signed, and faxed to your
Admissions Advisor’s e-fax number. This form must be completed and submitted as part of your Kaplan University record.
Please print legibly.
I, _______________________________________________, have applied for admission as a Graduate School of Management student at Kaplan University.
(NAME)
I understand that one of the requirements for admission to the Master of Business Administration (MBA) degree program at Kaplan University is a
baccalaureate degree from a regionally accredited institution or an institution accredited by an agency recognized by the U.S. Department of
Education, with a cumulative grade point average (GPA) of 2.5 or greater.
I understand that even if I attest to having the required cumulative GPA of 2.5, Kaplan University must still receive my official transcripts by the last
calendar day of my second term (approximately 12 weeks).
I understand that if my official transcript is not received by Kaplan University by the last calendar day of my second term, I will not be allowed to start
the third term. I understand that all Title IV financial aid must be refunded to the appropriate source, and that I will be responsible for paying all
amounts owed to Kaplan University directly.
I understand that if my official transcripts reflect a cumulative GPA of less than 2.5 my continued enrollment in the MBA program is subject to
approval by the Dean. Further, justification for acceptance will include a resume detailing related work experience in the field of business. If approval is
granted, I understand that I am required to take and pass KU 500: Foundations of Graduate Learning prior to enrolling in the subsequent term. If
approval is not granted, I will be deemed inadmissible and any and all financial aid that was disbursed on my behalf must be refunded to the appropriate source, and I will be responsible for payment of the funds to the original source or to Kaplan University.
I understand that in order to be successful in the MBA program I must acquire competencies in economics, accounting, and finance. If my official
transcripts or my work experience do not reflect such a background, I should acquire those competencies before taking the corresponding graduate
courses. I understand that I may acquire those competencies through the completion of two foundation courses offered by Kaplan University
(KU 510: Foundations of Mathematics and Economics and KU 511: Foundations of Accounting and Finance) which are specifically designed to expose
students to these essential skills. I understand that financial aid does not cover such courses and I will be responsible for payment in full.
I acknowledge that I have received a copy of the Kaplan University Catalog, available at www.kaplan.edu/ku/downloads.
If, for any reason, this attestation is found to be false or untrue, I understand that I will be subject to immediate dismissal from the University, all credits I have earned will be invalidated, and the University may take all other appropriate actions.
Furthermore, I understand that if this attestation is found to be false or untrue, all Title IV financial aid or any state or institutional financial aid that
was disbursed on my behalf must be refunded to the appropriate source, and that I will be responsible for payment of these funds to the original
source or to Kaplan University if the University is required to and has refunded such funds on my behalf.
By signing my name below, I attest that the information I have provided is true and correct to the best of my knowledge. I understand and agree to the
requirements, policies, and disclosures hereunder.
Signature _X
_____________________________________________________________________ Date _X
_______________________________________
ATTEST (Revised 12/05)
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ONLINE REGISTRAR’S OFFICE
550 West Van Buren, 7th Floor
Chicago, IL 60607
Tel: 312.777.6333
ADMISSIONS DEPARTMENT
6301 Kaplan University Avenue
Fort Lauderdale, FL 33309
Tel: 866.527.5268 (Toll Free)
Tel: 954.515.4700
Master of Science in Criminal Justice Degree Program Attestation
Please note: In order to attend Kaplan University, all Master of Science in Criminal Justice (MSCJ) program students must acknowledge, attest to,
and adhere to the following admissions requirements, policies, and disclosures. The following form should be completed, signed, and faxed to
your Admissions Advisor’s e-fax number. This form must be completed and submitted as part of your Kaplan University record.
Please print legibly.
I, _______________________________________________, have applied for admission as a Graduate School of Criminal Justice student at Kaplan University.
(NAME)
I understand that one of the requirements for admission to the Master of Science in Criminal Justice (MSCJ) degree program at Kaplan University is a
baccalaureate degree from a regionally accredited institution or an institution accredited by an agency recognized by the U.S. Department of Education,
with a cumulative grade point average (GPA) of 2.5 or greater.
I understand that even if I attest to having the required GPA of 2.5, Kaplan University must still receive my official transcripts by the last calendar day
of my first term.
I understand that if my official transcript is not received by Kaplan University by the last calendar day of my first term, I will not be allowed to start
the second term. I understand that all Title IV financial aid must be refunded to the appropriate source, and that I will be responsible for paying all
amounts owed to Kaplan University directly.
I understand that if my official transcripts reflect a GPA of less than 2.5, my continued enrollment in the MSCJ degree program is subject to approval
by the Dean. Further justification for acceptance will include a resume detailing related work experience in the field of criminal justice. If approval is
granted, I understand that I am required to take and pass KU 500: Foundations of Graduate Learning prior to enrolling in the subsequent term. If
approval is not granted, I will be deemed inadmissible and any and all financial aid that was disbursed on my behalf must be refunded to the appropriate source, and I will be responsible for payment of the funds to the original source or to Kaplan University. Such admission may require the successful
completion of a specified number of undergraduate criminal justice courses per the direction of the Dean. I understand that financial aid does not
cover these courses and I will be responsible for payment in full.
I understand that I must declare my choice of Thesis Track or Nonthesis Track at the latest by the end of my second term as a graduate student, and
that if I chose to elect a specialization, I must also do so before the end of the second term.
I acknowledge that I have received a copy of the Kaplan University Catalog, available at www.kaplan.edu/ku/downloads.
If, for any reason, this attestation is found to be false or untrue, I understand that I will be subject to immediate dismissal from the University, all credits I have earned will be invalidated, and the University may take all other appropriate actions.
Furthermore, I understand that if this attestation is found to be false or untrue, all Title IV financial aid or any state or institutional financial aid that
was disbursed on my behalf must be refunded to the appropriate source, and that I will be responsible for payment of these funds to the original
source or to Kaplan University, if the University is required to and has refunded such funds on my behalf.
By signing my name below, I attest that the information I have provided is true and correct to the best of my knowledge. I understand and agree to the
requirements, policies, and disclosures hereunder.
Signature _X
_____________________________________________________________________ Date _______________________________________
_X
_
ATTEST (Revised 12/05)
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ONLINE REGISTRAR’S OFFICE
550 West Van Buren, 7th Floor
Chicago, IL 60607
Tel: 312.777.6333
ADMISSIONS DEPARTMENT
6301 Kaplan University Avenue
Fort Lauderdale, FL 33309
Tel: 866.527.5268 (Toll Free)
Tel: 954.515.4700
Master of Education Program Attestation
This form must be completed and submitted as part of your Kaplan University record and should be faxed to your Admissions Advisor’s e-fax number.
Please note: In order to attend Kaplan University, all students must acknowledge, adhere, and attest to the following admissions requirements, policies, and
disclosures. The following form should be completed, signed, and faxed to your Admissions Advisor’s e-fax number. This form must be completed and submitted
as part of your Kaplan University record.
Please print legibly.
I, _______________________________________________, have applied for admission as a Graduate School of Education student at Kaplan University.
(NAME)
I understand that one of the requirements for admission to Kaplan University is that I have earned a bachelor’s degree from a college or university accredited by a
regional or national accrediting agency as recognized by the U.S. Department of Education or that I will have earned a bachelor’s degree from a college or university
accredited by a regional or national accrediting agency as recognized by the U.S. Department of Education prior to the start date of the term I am applying for.
I understand that even if I attest to having the required bachelor’s degree from a college or university accredited by a regional or national accrediting agency as
recognized by the U.S. Department of Education, Kaplan University must still receive my official transcripts by the last calendar day of my first term. I understand that if my official transcript is not received by Kaplan University by this date, I will not be allowed to start the second term. I understand that all Title IV
financial aid must be refunded to the appropriate source, and that I will be responsible for paying all amounts owed to Kaplan University directly. I understand
that Kaplan University requires that applicants have achieved a minimum cumulative grade point average (CGPA) of 2.5 out of 4.0 on baccalaureate coursework.
Candidates who do not meet this requirement may submit an official transcript indicating a minimum CGPA of 3.0 from a master’s degree or higher or from at
least three graduate courses taken at a regionally or nationally accredited university to be used in lieu of the minimum bachelor's degree CGPA required for
admission.
I understand that if my transcripts show that I do not possess the required bachelor’s degree from a college or university accredited by a regional or national
accrediting agency as recognized by the U.S. Department of Education, any and all financial aid that was disbursed on my behalf must be refunded to the
appropriate source, and I will be responsible for payment of these funds to the original source or to Kaplan University.
Students who completed their university education abroad must have earned an equivalent recognized baccalaureate degree. Students must request a
course-by-course translation and evaluation by one of the approved agencies listed by the National Association of Credential Services at the following
website: www.naces.org/members.htm. Official evaluated transcripts of international programs must be received by Kaplan University prior to enrolling in
the program. Foreign applicants who possess a bachelor’s degree from an institution in which English was not the primary language must submit official
TOEFL scores of at least 550 (paper format) or 213 (online format). The Dean has final discretion to approve candidates into a program.
I understand that candidates not meeting the content requirements in their certification area must take the recommended additional coursework at a college or
university of their choice accredited by a regional or national accrediting agency recognized by the U.S. Department of Education prior to student teaching.
I understand that candidates for the Master of Education will be required to complete a minimum of 100 hours of field work (8 hours per week) prior to
student teaching, and that my schedule must be flexible to accommodate this. Candidates will be required to set up a field experience schedule with field
supervisors and practicum teachers prior to the start of each term.
Immunization may be required prior to student teaching.
I understand that candidates for the Master of Education in Iowa will apply for an initial teacher license from the state of Iowa and that a second background
check will be required at this time.
I understand that I must submit passing scores on the Praxis II test to Kaplan University by Friday of week 5 of the second term. Washington, DC candidates
must provide proof of passing scores prior to enrollment. In lieu of Praxis tests, Kaplan University may accept passing scores on state examinations required
for licensure to teach. For states that require their own exams, candidates must submit passing scores (as determined by their state) on subject area exam(s)
by the middle of the second term (as defined above).
I understand that I will be required to devote a full-time schedule during student teaching, and that my schedule must accommodate this.
In order to be in the Master of Education program in Washington, DC, candidates in this region must submit a Form 4 (Application for Provisional Licensure
through an Alternative Route) with appropriate fee to the Program Director by the end of the first term.
The Master of Education program and curriculum have been designed to provide students with the background and practical experience that meet nationally
recognized standards for such a degree. However, individual state licensing requirements vary and may change from time to time. Thus, Kaplan University makes
no representations or warranties as to whether the degree program meets the specific licensing requirements for any individual state. Kaplan University suggests,
and encourages, its students to independently research the licensing requirements in any state in which they intend to seek licensure.
1 of 2
Initials
ATTEST (Revised 07/07)
If, for any reason, this attestation is found to be false or untrue, I understand that I will be subject to immediate dismissal from the University, all credits I have
earned will be invalidated, and the University will take all other appropriate actions.
Furthermore, I understand that if this attestation is found to be false or untrue, all Title IV financial aid or any state or institutional financial aid that was disbursed
on my behalf must be refunded to the appropriate source, and that I will be responsible for payment of these funds to the original source or to Kaplan
University, if the University is required to and has refunded such funds on my behalf.
By signing my name below, I attest that the information I have provided is true and correct to the best of my knowledge, and I understand all penalties and
consequences that I could encounter.
Signature _X
_____________________________________________________________________ Date _X
_______________________________________
2 of 2
Revised 07/07
ONLINE REGISTRAR’S OFFICE
550 West Van Buren, 7th Floor
Chicago, IL 60607
Tel: 312.777.6333
ADMISSIONS DEPARTMENT
6301 Kaplan University Avenue
Fort Lauderdale, FL 33309
Tel: 866.527.5268 (Toll Free)
Tel: 954.515.4700
Statement Regarding Credit Balances
This form must be completed and submitted as part of your Kaplan University record and should be faxed to your Admissions Advisor’s e-fax number.
Please print legibly.
STUDENT’S NAME _______________________________________________ SOCIAL SECURITY # _______________________________________
I am aware that when my current tuition, fees, and other allowable charges have been paid, my account will have a credit balance. I am requesting that
the balance be handled in the following manner (check all that apply):
The University should retain any existing credit balance on my account to be applied to allowable future charges to assist me in managing those
funds or to be disbursed to me at my request.
In the event that I do not request the funds prior to leaving school, the University should return the credit balance to the lender as payment
on my student loan.
Student Certification
I understand that the University will retain any interest earned on the credit balance while the school is holding these funds.
I may rescind this authorization to retain the credit balance at any time during the student’s attendance in the program.
I understand that the University may consider this authorization to be in effect throughout the student’s award year or period of enrollment unless
rescinded by the student/parent.
_____________________________________________________________________ Date _X
________________________________________
Student _X
(Signature required)
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QEC-084 (Revised 03/06)