History Department | University of Indianapolis

College of Arts & Sciences: Graduate Program Application

*Indicates required fields

*Name Full Legal Name

*Address Mailing Address

City

State

Zip

*Contact Information Home Phone Format: (555) 555-5555

Business Phone Format: (555) 555-5555

Email

*Demographics Country of Citizenship

Country of Birth

Are you of Hispanic/Latino descent?Yes

No

Gender
Male
Female

Date of Birth

*Academic Interest Graduate Program of Interest

Desired Start Date
Semester I
Semester II

Academic History

*Previous University of Indianapolis Attendance
Yes
No

*GRE Date taken

Date anticipated

TOEFL Date taken

Date anticipated

List chronologically every college, university or professional school you have attended, whether or not credit was earned.
Official transcripts from each school must be sent directly to the:
College of Arts and Sciences Graduate Programs
1400 East Hanna Avenue
Indianapolis, IN 46227
Additional information may be requested by the specific program to which you are applying.

*School #1 Name of Institution

City

State

From Date

To Date

Degree Received

Degree

Major

Date degree has been or will be received

School #2 Name of Institution

City

State

From Date

To Date

Degree Received

Degree

Major

Date degree has been or will be received

School #3 Name of Institution

City

State

From

To

Degree Received

Degree

Major

Date degree has been or will be received

*List any licenses or certifications or advanced training that you hold.

Past Employment

List your employment chronologically for the past five years. Include service with the armed forces.

*Employer #1 Employer Name

Employer Location

From

To

Description of Work

Employer #2 Employer Name

Employer Location

From

To

Description of Work