RIT Application for Graduate Study

* Required field

Personal Information

First (Given) Name *
Middle Name
Last (Family) Name *
Prior or Maiden Name
Gender	M F
Date of Birth *
Telephone (Home)
Telephone (Mobile)
E-mail *
Are you a U.S. citizen?	Yes No
U.S. Permanent Resident/Green Card?	Yes No
Will you need a visa form (I-20 or DS-2019) issued by RIT?	Yes No
If you currently hold a valid U.S. visa, indicate type:	Student (F) Exchange Visitor (J) Other (Please specify)
Country of Citizenship
Native Language
City and Country of Birth

Permanent Mailing Address

Country *
Address *
Address 2
City *
Non-U.S. State/Province
State (U.S.)
ZIP (Postal) Code

Current Mailing Address (if different than above)

Country
Address
Address 2
City
Non-U.S. State/Province
State (U.S.)
ZIP (Postal) Code
Current Telephone
Until what date can we reach you at your current mailing address?

Program Choice

Major/Program Title *
How do you plan to complete most of your graduate courses?	Attend classes on RIT campus Exclusively through online learning Full time A combination of on-campus and online classes Executive Leader option Part time Attend classes off campus at
Indicate the calendar year and quarter term you plan to begin your studies. *	Winter Quarter 2012 Spring Quarter 2012 Summer Quarter 2012 Fall Semester 2013 Spring Semester 2013

Scholarships and Assistantships

Do you wish to be considered for a graduate scholarship? *	Yes No
Are you planning to apply for a graduate assistantship? *	Yes No

(Please visit our website, www.rit.edu/grad, for assistantship information.)

Financial Support

Are you currently employed? *	Yes No
If yes, will your employer provide payment or reimbursement for any portion of your educational expense?	Yes No
If yes, please provide name of employer and amount of reimbursement provided:
Employer Name
Reimbursement Amount
Are you an RIT employee?	Yes No
Are you a family member of an RIT employee and eligible to receive tuition benefits?	Yes No
List any sources of non-RIT financial support that you expect to receive for the coming academic year (e.g., corporate, government support, NSF, etc.):
Source of support
Dates provided
Amount in U.S. dollars

Applicant Status

Are you receiving or seeking support services from RIT’s National Technical Institute for the Deaf? *	Yes No
Have you previously applied to RIT? *	Yes No
If yes, indicate term/year and program applied to:
Have you previously attended RIT?	Yes No
If yes, indicate RIT academic program and years attended:
Please list other colleges and universities to which you are applying for admission:

Education

Please list all universities and graduate schools you have attended or are currently attending.

Name of Institution	City, State, Country	Start / End Date	Credits Earned	Degree(s) Received or Expected & Date	Major Field

If you are currently taking college or university courses, please list them below:

Course Title	Course Title

Indicate the date you took or will take any required admission tests (see our website, www.rit.edu/grad, to determine if any admission test is required for your program). Please note: For verification purposes, test scores must be sent by the testing agency directly to the Office of Graduate Enrollment Services at RIT.

Test Type (GRE, TOEFL, GMAT, MAT)	Test Score (if known)	Test Date or Anticipated Test Date

Work Experience / Personal Data

You may forward a résumé or curriculum vitae to gradinfo@rit.edu or forward it along with other application materials. In your résumé or curriculum vitae, please describe your full-time, part-time, and summer employment (include military service). Include your academic honors, published works, and leadership roles. List any academic, artistic, professional, military, or community activities you consider significant to your proposed graduate study.

Personal Statement of Educational Objectives

You may forward a personal statement describing your educational objectives to gradinfo@rit.edu, or forward it along with your other application materials. You may wish to address: (1) why you are applying for your chosen degree program, (2) what you hope to achieve through your education, (3) how your degree program will relate to your long-range career objectives, (4) what personal or “non-academic” qualities you will contribute to the learning environment in your program, (5) what (if any) prior experience you have with respect to your chosen program, and (6) specifically why you want to attend RIT.

Personal Conduct

Have you ever been subjected to disciplinary action by any school, college, university, or branch of the military (If yes, briefly explain below.) *	Yes No
Explanation
Have you ever been convicted of a violation of any state or federal law, excluding minor traffic violations? (If yes, briefly explain below.) *	Yes No
Explanation

Optional Information

The following questions are optional. Refusal to provide this information will not affect decisions related to graduate admission, scholarship or assistantship awards, or financial aid. Any information provided will remain confidential.

If you wish to be identified with a particular ethnic or racial group, please indicate how you would describe yourself:	African American, Black American Indian, Alaskan Native Hispanic, Latino Asian, Pacific Islander White, Caucasian Other
Other surname used (on school transcripts, etc.)
How did you first learn about RIT’s graduate programs? (website, e-mail, brochure, etc.)