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Inter-University Doctoral Consortium Registration Form / / Graduate Center, CUNY / New School for Social Research / / / / Teachers , Columbia University Instructions for the Inter-University Doctoral Consortium Registration Form

Student: 1. Please print all information clearly and legibly. 2. Contact the IUDC Coordinator’s Office at the Home School as well as the Home School IUDC website 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. 4. Host School IUDC Coordinator will not sign this form unless all other signatures are present.

PERSONAL INFORMATION

Last Name First Name MI

Student ID # Term Started in Program: Fall / Spring (please circle) 20 *

Date of Birth Term for IUDC Course Enrollment: Fall / Spring (please circle) 20

Address

Home School E-mail Address Phone #

*NOTE: To be eligible, must be within seven years of full-time study (or the equivalent) from the date of first enrollment.

HOME SCHOOL INFORMATION

Home School: Have you completed one full year of YES or NO enrollment or the equivalent? (please circle) q Ph.D. Department or Division: Degree (consortium is for doctoral students only): q Ed.D.

Home School Chair or Program Director/Advisor (Signature) Date

Home School IUDC Coordinator (Signature) Date By signing this form, the Home School IUDC Coordinator certifies that the student is in good standing and has met all immunization requirements of New York and .

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

[See attached contact information.] CONTACT INFORMATION

IUDC

COLUMBIA UNIVERSITY, GSAS PRINCETON UNIVERSITY Sarah Jackman, Graduate Student Affairs Officer Elaine Willey, Assistant Dean [email protected] [email protected] Office of Student Affairs Alyssa Pienciak, Academic Affairs Coordinator 107 Low Memorial Library [email protected] 535 West 116th St Office of Academic Affairs Phone: (212) 854-6724 The New York, NY 10027 111 Clio Hall Columbia IUDC Website Princeton, NJ 08544 Phone: (609) 258-3168 Princeton IUDC Website CUNY GRADUATE CENTER

Matthew Schoengood, Vice President for Student Affairs Vincent J. DeLuca, Registrar RUTGERS UNIVERSITY, NEW BRUNSWICK [email protected] Alexandria Bachmann, Administrator for Office of Vice President for Student Affairs Academic Support & Student Services 365 Fifth Avenue, Room 7301 [email protected] New York, NY 10016 Office of the Dean, School of Graduate Studies Phone: (212) 817-7409 Rutgers, the State University of New Jersey CUNY IUDC Website 25 Bishop Place New Brunswick, NJ 08901-1181 Phone: (848) 932-7449 FORDHAM UNIVERSITY, GSAS Rutgers IUDC Website Joanne Schwind, Assistant Dean [email protected] Office of Academic Programs & Support STONY BROOK UNIVERSITY Keating Hall, Rm. 216 Melissa Jordan, Assistant Dean for Records and 441 E. Fordham Rd. Admissions Bronx, NY 10458 [email protected] Phone: (718) 817-4406 Office of the Dean, The Graduate School Fordham IUDC Website Stony Brook University Stony Brook, NY 11794-4433 Phone: (631) 632-9712 NEW SCHOOL FOR SOCIAL RESEARCH Tsuya Yee, Associate Dean for Academic Affairs Stony Brook IUDC Website P. J. Gorre, Coordinator of Academic Affairs [email protected] TEACHERS COLLEGE, COLUMBIA Office of Academic Affairs UNIVERSITY th 6 East 16 St, Room 1007 Megan Massaro, Registrar New York, NY 10003 [email protected] Phone: (212) 229-5712 Office of the Registrar New School IUDC Website 525 West 120th Street New York, NY 10027 NEW YORK UNIVERSITY Phone: (212) 678-4055 Allan Corns, Assistant Dean, Academic Affairs Teachers College IUDC Website Li Cao, Assistant Director, Academic Affairs [email protected] New York University 6 Washington Square North, 2nd Floor New York, NY 10003 Phone: (212) 998-3716 NYU IUDC Website