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Inter-University Doctoral Consortium Registration Form Columbia

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Inter-University Doctoral Consortium Registration Form Columbia Inter-University Doctoral Consortium Registration Form Columbia University / Fordham University / Graduate Center, CUNY / New York University New School for Social Research / Princeton University / Rutgers University / Stony Brook University / Teacher’s College, Columbia University Instructions for the Inter-University Doctoral Consortium Registration Form Student: 1. Please print all information. 2. Contact the IUDC Coordinator’s Office at the Home School for instructions on completing administrative matters there FIRST. 3. If necessary, contact the IUDC Coordinator’s Office at the Host School for instructions on completing administrative matters there. Please review instructions at IUDC website: http://gsas.columbia.edu/iudc 4. Make 2 copies of this form: 1 for the Host School and 1 for your own records. Return the original copy to the IUDC Coordinator’s Office at the Home School. PERSONAL INFORMATION Last Name First Name MI Student ID # Term Started in Program: Fall / Spring (please circle) 20 Date of Birth SS# Term for IUDC Course Enrollment: Fall / Spring (please circle) 20 Address Home School E-mail Address Phone # HOME SCHOOL INFORMATION Home School: Have you completed one full year of YES or NO enrollment or the equivalent? (please circle) Are you in good standing and within seven years (full-time) equivalent study? YES or NO (please circle) Department or Division: Degree (consortium is for doctoral students only): □ Ph.D. □ Ed.D. Home School Chair or Program Director/Advisor (Signature) Date: Home School IUDC Coordinator (Signature) Date: HOST SCHOOL INFORMATION Host School: Department and Division: Course #/Section # Course Title: Course Credits: Host Instructor (Signature) Please Print Name Date Host School IUDC Coordinator (Signature) Date TO DROP THIS COURSE, SIGN BELOW AND SUBMIT THIS COPY TO THE HOST UNIVERSITY. IN ADDITION, PLEASE FOLLOW YOUR HOME SCHOOL’S GUIDELINES REGARDING WITHDRAWING AND/OR DROPPING THE COURSE. Student Signature Date I AUTHORIZE THE RELEASE OF MY ACADEMIC TRANSCRIPT TO THE IUDC COORDINATOR AT MY HOME INSTITUTION AFTER THE FINAL GRADE HAS BEEN POSTED TO MY RECORD. Student Signature Date PLEASE NOTE: Consortium students are only able to CONTACT INFORMATION register for classes within the graduate programs in the IUDC arts and sciences at the schools listed below. COLUMBIA UNIVERSITY, GSAS NEW SCHOOL FOR SOCIAL RESEARCH RUTGERS UNIVERSITY, NEW BRUNSWICK Craig Knobles, Administrative Assistant Tanya Nguyen, Senior Office Assistant Alexandria Bachmann, Administrator for j ck2@col umbi a.edu [email protected] Academic Support and Student Services Office of Student Affairs Office of Academic Affairs [email protected] 107 Low Library 6 East 16th Street, Room 1007 Office of the Dean, Graduate School-New New York, NY 10027 New York, NY 10003 Brunswick Phone: (212) 854 -5052 Phone: (212) 229-5712 x3002 Rutgers, the State University of New Jersey gsas.columbia.edu www.newschool.edu/nssr 25 Bishop Place New Brunswick, NJ 08901-1181 CUNY GRADUATE CENTER NEW YORK UNIVERSITY Phone: (848) 932-7449 Matthew Schoengood, Vice President of Allan Corns http://gsnb.rutgers.edu Student Affairs [email protected] [email protected] Office of the Vice Dean, GSAS STONY BR OOK UNIVERSITY Sheila Berman, Administrative Assistant New York University Melissa Jordan, Asst. Dean for nd [email protected] 6 Washington Square North, 2 Floor Records & Admission Vincent J. DeLuca, Director of Student New York, NY 10003 [email protected] Services and Registrar Phone: (212) 998-8030 Office of the Dean, The Graduate School [email protected] gsas.nyu.edu Stony Brook University Office of Vice President for Student Affairs Stony Brook, NY 11794-4433 365 Fifth Avenue, Room 7301 Phone: (631) 632-9712 New York, NY 10016 http://www.grad.sunysb.edu PRINCETON UNIVERSITY Phone: (212) 817-7400 Alyssa Martilotti, Academic Affairs www.gc.cuny.edu TEACHERS CO LLEGE, CO LUMBIA Coordinator UNIVERSITY FO RDHAM UNI VERSITY, GSAS [email protected] Diana R. Maul, Registrar Office of Academic Affairs Jennifer Latham, Director [email protected] The Graduate School Joanne Schwind Office of the Registrar 111 Clio Hall [email protected] 525 West 120th Street Princeton, NJ 08544 Associate Dean’s Office New York, NY 10027 Phone: (609) 258-3168 Keating Hall, Rm. 216 Phone: (212) 678-4055 http://gso.princeton.edu 441 E. Fordham Road www.tc.columbia.edu Bronx, NY 10458 Phone: (718) 817-4406 www.fordham.edu/gsas Updated 19-June-13 .
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