College of Staten Island - Application for Graduate Admission

Application for Graduate Admission

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Application for Graduate Admission
Step 1 of 9

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Instructions to Applicant
Read each section carefully before starting to answer. All supporting documents should be sent to the address indicated at the end of this application. Please note, there is a special address indicated for applicants to the Master’s program in Nursing.

An application fee is required of all applicants and is non-refundable. The fee is $75. It must be mailed or delivered to the Office of Recruitment and Admissions. Please make your check or money order payable to the College of Staten Island and be sure that your name appears on the face of the check. Applicants from outside the United States must remit the fee by a check drawn on a U.S. bank.

I am applying for:

Biographical Information
Note: The City University does not discriminate on the basis of age, sex, race, creed, national origin, physical or mental disability, sexual orientation, marital status, veteran’s status, and alienage or citizenship status.

Salutation:

Last Name:

First Name:

Middle Name:

Suffix:

Social Security Number: I do not have a Social Security Number.

I have previously used a different name.

Gender: Male Female

Date of Birth: Please enter as MM/DD/YYYY

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Country:

Address: Apartment:

Address 2:

City: State: Zip Code:

I have a different mailing address.

Address: Apartment:

Address 2:

City: State: Zip Code:

Country:

Length of time at above address:

Length of time in New York City:

Length of time in New York State:

Daytime Telephone:

Evening/Alternate Telephone: (Optional)

Email Address:
Email Address (confirmation):

Degree Type:

Programs for the selected degree above: