Graduate Education Application

NOTE: The Principal Licensure Program has a separate application process. Please see the program page for details or contact the Admissions Coordinator for an application packet. Do not use this form.

Semester applying for: *

Contact Information

Email address: *

Your Name

First name: *

Middle name:

Last name: *

Preferred first name:

Birthdate

Birthdate:

Permanent Address

Street address:

City:

State:

Zip code:

County (Ky. residents only):

Phone Numbers

Home phone:

Work phone:

Cell phone:

Fax number:

Current Employment

Place of employment:

Position:

Address:

County (Ky. residents only):

Birth Place

City:

State:

Country:

Country of Citizenship

Country:

Type of visa:

Gender/Ethnic Origin(optional)

Asbury University is asked to report gender and ethnic origin data on applicants. Response to these requests is optional; however, we would ask that applicants volunteer this information. This information will be used for state and federal statistical reporting purposes, and will not in any way be part of the University's admissions decision with regard to the applicant.

Gender:

Ethnic origin:

Academic Information

Chronologically list all colleges and universities attended or attending. Include the following information:

Dates attended
Location of school (city and state)
Degrees or credits earned
Indicate if you were ever dismissed or suspended

Please request all institutions to send official college transcripts to: Graduate Education Program
Asbury University
One Macklem Drive
Wilmore, KY 40390

Colleges and universities:

Area of Interest

Indicate the graduate area for which you are applying.

MA in Education: Regular certification track (select one): (Initial certificate required in an area of education)

Choose an emphasis:

MA in Education: Alternative certification track (select one): (Bachelor's degree required)

Choose an emphasis:

Other:

Single Course or Non-degree seeking (9 hrs. maximum)

Certification

Do you currently hold a teaching certificate?:

If yes, complete the following:

Will your Asbury University degree/hours be applied toward Rank I or Rank II status?:

Please list any certifications you have in the box below. Include the following information:

Area
Date of Expiration
Type of Certificate
State of Issuance

Certifications:

Community Expectations

Asbury University is a Christian, liberal arts institution. No official denominational emphasis exists at Asbury University and those of all denominational backgrounds may participate fully in the spiritual life of the campus. The institution maintains a doctrinal commitment to an evangelical Wesleyan-Arminian perspective. We are committed to academic excellence and spiritual vitality for a lifetime of learning, leadership, and service to the professions, society, family, and the Church.

Please read Asbury's Community Expectations (see downloadable PDF.)

Community expectations: *

Are you willing to abide by these guidelines during enrollment at Asbury University?

Denomination

What is your denominational preference or affiliation?:

Other Information

How did you hear about Asbury University?: *

Why did you select Asbury University?:

Accuracy of Information

Legal statement:

I hereby make application to Asbury University and certify the truthfulness of the answers given herein. I understand that I am responsible for arranging the forwarding of official transcripts of all schools I have attended or am attending and official scores of national tests I have taken or will take. Such documents become the property of Asbury University and will not be returned to me.