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Application for Graduate Admissionsfor U.S. Citizens and Permanent ResidentsApplication ChecklistChecklist for Graduate School Admissions Application, completed in its entirety In-state tuition request form (printed page 7), if applicable Official transcript(s) from all institutions where a degreewas received or graduate level work was taken. Application fee (Please review and attach thePayment Processing Form, printed page 9.) Official test scores should be sent to GraduateSchool Admissions (ETS Institution Code: 5859)Checklist for Your Department/ProgramAgriculture & Life Sciences www.cals.vt.edu540/231-6503Architecture & Urban Studies www.caus.vt.edu540/231-6386Business (Pamplin) www.pamplin.vt.edu540/231-6152Engineering www.eng.vt.edu540/231-9171Liberal Arts & Human Sciences www.clahs.vt.edu540/231-6779Natural Resources www.cnr.vt.edu540/231-7051Sciences www.cos.vt.edu540/231-5145540/231-4992 Letters of recommendation (make sure tolist each evaluator in the application) Official transcript(s) from all institutions where a degreewas received or graduate level work was taken to the department Statement of PurposeBiomedical & Veterinary Sciences www.vetmed.vt.edu Supplemental informationCampuses Across Virginia Test scores (GRE, GMAT, and/or TOEFL)Blacksburg (main campus) www.vt.edu540/231-8636National Capital Region www.ncr.vt.edu703/538-8327Check the website of the department for specific details on their requirements.Test ScoresTest ScoresCollege Contact InformationWhile we ask that you report your scores on this application, theofficial information must come from the respective testing agencies.Applications are not considered complete until this information isreported by the testing agencies.Educational Testing Services (ETS) Institution Code is 5859.Graduate Management Admissions Test (GMAT) Institution Codes are:53B-XS-08 MBA, Full-time (Blacksburg)53B-XS-06 PMBA, Full-time (Richmond/Roanoke)53B-XS-35 EMBA, Full-time (National Capital Region)53B-XS-97 MBA, Part-time (National Capital Region)53B-XS-34 ACIS, (Blacksburg)53B-XS-59 PhD Programs (Blacksburg)Hampton Roads www.hrc.vt.eduRichmond www.richmond.vt.edu804/662-7286Roanoke www.roanoke.vt.edu540/767-6100Southwest Virginia www.swcenter.vt.edu276/619-4311Virtual Campus www.vto.vt.edu540/231-1264Financial AidFinancial Aid InformationIf you are a U.S. Citizen or Permanent Resident, you may want toconsider financial aid opportunities. The Virginia Tech Office ofUniversity Scholarships and Financial Aid can provide informationabout funding opportunities at www.finaid.vt.edu. You must file a FreeApplication for Federal Student Aid (FAFSA) atwww.fafsa.ed.gov to be considered for this aid.Financial assistance may be available through the department towhich you are applying in the form of an assistantship (GTA/GRA) orfellowships. Check with your intended department for more information.Virginia Tech does not discriminate against employees, students, or applicantson the basis of race, color, sex, sexual orientation, disability, age, veteran status,national origin, religion, or political affiliation. Anyone having questions concerningdiscrimination or accessibility should contact the Office for Equal Opportunity.Graduate Application for U.s. Citizens/Permanent Residents757/363-3930 x301Application DeadlinesFallSpringJuly 1December 1Summer 1April 15Summer 2June 1Send application and payment to:Northern Virginia Center7054 Haycock Road, Suite 200Graduate Student Services OfficeFalls Church, VA 22043Fax: 703/538-8320Questions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.
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Application for Graduate Admissionsfor U.S. Citizens and Permanent ResidentsLast/Family NameFirst/Given NameList any former names:SuffixEnrollment InformationTerm of EnrollmentSocial Security Number: Fall Spring Summer I Summer IIStudent ID Number (if applicable):Campus Current Mailing AddressGeneral InfoMiddle NameyearBlacksburg (Main)*Hampton RoadsNational Capital RegionRichmondRoanokeSouthwest VirginiaVirtual*Blacksburg should be selected if the campus at whichyou intend to enroll is not listed. Provide details on thesupplemental form, page 3 of this application.cityCurrentDaytime Phone:CurrentEvening Phone:statezipcountryPlease list your primaryphone and e-mail. Wevalue your privacy andwill not disclose yourinformation. Home Office Mobile Home Office MobileDegree Level Doctoral Education Specialist Masters Graduate Certificate Non-Degree Commonwealth campusE-mail Address:Desired ProgramPermanent/Home Country Address (if different):Virginia Tech Undergraduateswho are applying to concurrently be in bothundergraduate and graduate status at thesame time, please indicate in which categoryyou will be applying: 152 HR ACIS Masters Degreecitystatezipcountry Bachelors/Masters Degree (Open)Permanent Daytime Phone: Home Office Mobile Dual Student Status Home Office Mobile Combined Student Status(Architecture only)Personal InfoPermanent Evening Phone:Personal InformationPlease answer both of the followingquestions:Are you Hispanic, Latino, or of SpanishOrigin ? Yes NoGender: Male FemaleDate of Birth: / / Bachelors/Masters Degree(Honors)(MM/DD/YY)Please select your race: choose all that apply.City of Birth: African American/BlackState of Birth: American Indian/Alaskan NativeCountry of Birth: AsianThe U.S. Department of Education hasrequested that we collect the followinginformation on race and ethnicity. Native Hawaiian/Pacific Islander WhiteGraduate Application for U.s.CITIZENS/Permanent ResidentsPage 1 of 3, September 2008, NCRCitizenship: U.S. Citizen Permanent Resident (copy of PR Card required)US State of Legal Residence:Are you claiming entitlement to Virginia in-statetuition rates pursuant to Section 23.7-4, Code ofVirginia? No Yes If yes, you must complete theGraduate In-State Tuition Request on page 7.Questions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.
Application for Graduate AdmissionsaCADEMIC hISTORYfor U.S. Citizens and Permanent ResidentsAcademic HistoryIn chronological order, beginning with the most recent, list any bachelor and/or graduate level work that you will have done prior toenrollment. Note that official transcript(s) must be sent to the Graduate School and to the academic department to which you are applying.Institution NameDegree TypeMajorGPADate Received/ExpectedLetters of RecommendationLetters of RecommendationPlease make sure that your referees have indicated in advance that they are willing to submit a reference form for you. Please keep inmind that it is your responsibility to ensure that your recommenders have submitted their forms by the appropriate deadline.Under the Family Educational Rights and Privacy Act of 1974, a student enrolled at Virginia Tech has access to his or her academicrecords. We comply with this law, while still allowing the student the option of waiving the right to access this specific document.Waiving this right does not preclude you from access to the rest of your academic records. If you wish to waive the right to examinethis evaluation at a later date, please indicate below. Your choice will not affect the consideration of your application to Virginia Tech.First ReferenceTitleDo you waive yourright to access thisFirst Name Last Nameevaluation? Yes No Institution/Company NameDaytime Phone:E-mail: Second ReferenceTitleDo you waive yourright to access thisFirst Name Last Nameevaluation? Yes No Institution/Company NameDaytime Phone:E-mail: Third ReferenceTitleDo you waive yourright to access thisFirst Name Last Nameevaluation? Yes No Institution/Company NameTest ScoresDaytime Phone:E-mail: While we ask that you report your scores here, the official scoring information must come from the respective testing agencies.GRE General TestTest Date:/Verbal Score: Quantitative Score:Analytical Writing Score:(MM/YY)GRE Subject TestGMAT ScoreSubject: Test Date:Test Date:Test Score: Graduate Application for U.s. Citizens/Permanent ResidentsPage 2 of 3, September 2008, NCR/(MM/YY)/(MM/YY)Test Score: Questions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.
gENERAL sUPPLEMENTAL fORMPrior to completing this form, check with the department to which you are applying to see if they require a more specificsupplemental form. Some departments have forms that replace this general one.Name:Date of Birth: / / (MM/DD/YY)Degree Program:Alternate Campus LocationFinancialGoals and ResumeIf you wish to take classes at a location other than the Virginia Tech campuses listed on printedpage 1 of this application, please list below.Academic and Professional Goals StatementPlease attach a 3 to 4 page double-spaced personal statement which includes the following: Why do you want to undertake graduate work?What do you expect to derive from your program of study?If you have a concentration in mind, briefly outline your interests in this area.What do you expect to contribute as a student and, subsequently, as a member of the profession?ResumeApplicants are asked to provide a resume outlining your most recent experiences or by listing those that are most relevant to your application.Financial AssistanceDo you wish to be considered for an assistantship or fellowship? Yes NoWill you be able to attend Virginia Tech without an assistantship or fellowship? Yes NoSignaturePledge of HonorReturn your completedSupplemental Form to:I certify that all information provided to the Graduate School and department on myapplication and during the entire admissions process is accurate. I understand that uponadmission and enrollment I will be subject to the rules and regulations of the university,including the Graduate Honor System (http://ghs.grads.vt.edu). Applicant SignatureThe department to whichyou are applying.Please visit your College’s website,listed on the cover sheet,for contact information.DateQuestions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.Graduate Application for U.s. Citizens/Permanent Residents, General SupplementalPage 3 of 3, September 2008, NCR
Additional Required InformationAdditional Required InformationHave you been convicted of or received a juvenile adjudication for a violation of any local,state, or federal law, other than a minor traffic violation? Yes NoAre you currently on court-ordered supervised or unsupervised probation or under the termsof a finding under advisement? Yes NoAdditional Required InformationPlease give a full explanation of any past criminal convictions:Return your completed form to:Northern Virginia Center7054 Haycock Road, Suite 200Graduate Student Services OfficeFalls Church, VA 22043 Fax: 703/538-8320Applicant SignatureDateQuestions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.Additional Required InformationPage 1 of 1, October 2008, NCR
Graduate In-State Tuition RequestIf you are being charged out-of-state tuition and believe you are eligible for in-state rates, please complete thefollowing form. You must be a U. S. citizen; a permanent resident alien; or hold an A, E, G, H-1 or H-4, K, or N visa toestablish residency that qualifies you for in-state tuition. Please attach a copy of your permanent resident alien cardor I-94, visa stamp, and/or other USCIS approval notification. You must also demonstrate intent to establish domicilein Virginia. The university requires additional supporting documentation demonstrating your residency qualificationfor the prior year. Please include a copy of your Virginia state income taxes, driver’s license, vehicle registration,voter registration, and lease/mortgage agreement. Failure to supply this information may result in the denial of yourrequest. Use the other side of this form to provide additional information to be considered on your application.Last/Family NameFirst/Given Nameif known U.S. CitizenDate of Birth: Permanent Resident Non-Resident Alien**If non-resident alien, please list your visa status:month/day/yearCurrent ProgramE-mail Address:Degree Level@vt.edu account, preferredDaytime Phone: Home Office MobileLocal Address DoctoralFirst Term of Enrollment Education Specialist Fall Spring Summer I Summer II MastersyearAnticipated Completion Term Fall Spring Summer I Summer IICampuscitystatezipHow long have you resided in Virginia?Prior Address 1:Prior Address 2:Required InfoSuffixCitizenshipStudent ID Number:Personal InfoMiddle NamecountryYears: Graduate Certificate Non-Degreeyear Commonwealth campus Blacksburg Hampton Roads National Capital Region Richmond Roanoke Southwest Virginia VirtualMonths:Beginning with the most recent, chronologically list theaddresses at which you have resided for the past two years.street addresscitystatezipcountrystreet addresscitystatezipcountryDo your parents/legal guardian/spouse provide over half of your financial support OR claim youas a dependent on their taxes? Yes NoIf yes, in which state do your parents reside?(If VA, attach a copy of their VA state income taxes.)For the twelve months prior to the term in which you will enroll, will you have:1. filed a tax return or paid income taxes to Virginia? Yes No2. been a registered voter in Virginia? Yes No3. held a valid Virginia Driver’s license? Yes No4. owned or operated a vehicle? Yes Noa. If yes, has it been registered in Virginia? Yes No5. Are you, or any member of your immediate family, enlisted in the Virginia National Guard? Yes No6. Are you, the spouse of, or the dependent of active-duty military personnel? Yes Noa. Are you/they permanently stationed in Virginia? (If yes, include a copy of your/their orders.) Yes Nob. Does your/their Leave and Earnings Statement reflect Virginia as the state of residence?(If yes, include a copy.) Yes No7. If you are active duty military, did your spouse earn at least 10,300 in the last year, claim you as afederal tax dependent, and pay income tax to the state of Virginia? Yes NoSignatureAnswer this question, only if you worked in Virginia for the past 12 months but currently live outside of Virginia.Did you file Virginia taxes on all income earned in Virginia for the last year? Yes NoI certify that all information provided to the Graduate School and department on myapplication and during the entire admissions process is accurate. I understand thatupon my admission and enrollment I will be subject to the rules and regulations of theuniversity, including the Graduate Honor System (http://grads.ghs.vt.edu).Applicant SignatureGraduate In-state Tuition RequestPage 1 of 1, August 2008, NCRdateReturn your completed form to:Northern Virginia Center7054 Haycock Road, Suite 200Graduate Student Services OfficeFalls Church, VA 22043 Fax: 703/538-8320Questions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.
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Payment Processing FormApplication and diploma reorder fees may be paid via credit card, check, or money order. Please complete theinformation below and submit this document with the corresponding application or form to the Graduate School.Last/Family NameFirst/Given NameRequired InfoStudent ID Number:Middle NameSuffixE-mail Address:@vt.edu account, preferredif knownDaytime Phone: Home Office MobilePlease process payment for: Degree-Seeking Application Fee (i.e. Masters and Doctoral Students) - 45 Executive Masters of Business administration (EMBA) Application Fee - 90 Application for Simultaneous Degrees - 45 Non-Degree-Seeking Application Fee (i.e. Commonwealth Campus and non-degree Programs) - 25 Application for Certificate Program - 25 Application for Readmission - 25 Application for Visiting Student - 25 Diploma Reorder - 20 Per DiplomaTo Pay Via Check or Money OrderEnclose your check or money order made payable to Treasurer, Virginia Tech.Checks and money orders must be drawn from a U.S. bank.To Pay Via Credit CardPlease complete the following information and sign below.Payment DetailsName as it appears on card:I, the card holder indicated above, authorize payment to be processed. I furtherunderstand that this is a non-refundable payment. Payment cannot be processed without asignature, and the application cannot be processed without payment.Return your completed form to:Northern Virginia Center7054 Haycock Road, Suite 200Graduate Student Services OfficeFalls Church, VA 22043Fax: 703/538-8320dateCardholder Signature Card Type: Visa MasterCardExpiration Date:month/yearThe security code is thethree-digit code located onthe back of the credit card.Credit Card NumberSecurity CodeQuestions? Call 703/538-8327 ore-mail gsso@nvc.vt.edu for assistance.Payment Processing FormPage 1 of 1, December 2008, NCR
hampton roads 757/363-3930 x301 www.hrc.vt.edu richmond 804/662-7286 www.richmond.vt.edu . 53B-Xs-08 mBa, full-time (Blacksburg) 53B-Xs-06 pmBa, full-time (richmond/roanoke) . admission and enrollment i will be subject to the rules and regulations of the university, including the Graduate honor system .
