B O R I C U A A C O L L E G E P P L I C A

T Graduate Admissions I Manhattan Campus Bronx Campus Center Brooklyn Campus Center 3755 Broadway 890 Washington Avenue 9 Graham Ave New York, NY 10032 Bronx, NY 10451 Brooklyn, NY 11206 212-694-1000 347-964-8600 718-963-4112 O [email protected] [email protected] [email protected]

Boricua College is accredited by the Middle States Commission on Higher Education N

PERSONAL INFORMATION:

Legal Name: ______Last (Family Name) First (Given Name) Middle Name

Maiden Name: ______(If Applicable)

Gender: Male Female Date of Birth: ___ / ___ / ___

Address: ______Street Name Apt. Number

______City State Zip Code Country

Cell Phone: ____ - ____ - ____ Alternate Phone: ____ - ____ - ____

Email Address: ______

ENROLLMENT INFORMATION:

APPLYING AS: Transfer Re-Admit Continuing

I am interested in: MASTER DEGREE

Human Services Education-TESOL Latin American & Caribbean Studies

INTENDED MAJOR:

I will register for: Fall of 20__ (Sept.) Spring of 20__ (Jan.)

Time: Evening

Campus/Location of Choice: Manhattan Bronx Brooklyn

EDUCATIONAL INFORMATION:

What will be your academic status at the time of enrollment?

I have earned a degree from Boricua College

I have earned a degree from another college or university

Please list below all the college(s) you have attended:

School Name Dates Attended

______

______

College Graduation Date: ______

Degree Earned: ______Major: ______

DEMOGRAPHIC INFORMATION:

Marital Status: Single Separated/ Divorced Date: ______

Married Date: ______Widowed Date: ______

Immigration Status:

U.S Citizen U.S Permanent Resident F-1 Student Status

Place of Birth: ______

Ethnicity: Hispanic/Puerto Rican Hispanic/Dominican Hispanic/Other

African American Asian White Other

Primary Language: ______Country of Origin: ______

Emergency Contact: ______Name Relationship to Student Phone Number

Military Service? No Yes If yes, please provide DD214/Military Separation Form

Medical Conditions? No Yes

If yes, explain condition below:

______

______

Are you disabled? No Yes _ If yes, please describe below and provide documentation. ______Disciplinary Questions:_ _ Have you ever been suspended_ , removed, dismissed or expelled from any school or academic institution? _ _ No Yes _ If yes, please explain why ______Have you_ ever been _convicted_ of any felony, misdemeanor or other crime? (Omit traffic _ offenses)______No Yes_ If yes, please describe offense and date of offense below: ______NOTE_: Answering yes_ to either of the two questions does not automatically bar you from __ _ _ _ admission to Boricua College ______REFERRAL INFORMATION:

How did you hear about Boricua College?

Current Boricua College Student Direct Mail _ _ Friend/Family Member Open House/College Fair _ _ _ _ _ Co-worker Newspaper/Other Advertisement _ _ _ _ _ Employer Guidance or College Counselor _ _ _ _ _ Boricua Alumni Association _ Flyer/Tabling

______Online _ Walk-in ______What_ are the most important reasons for choosing to_ attend Boricua College? (check all _ _ that _apply) ______Academic Major _ Small Class Size Colloquium _ _ _ _ _ Career Advancement _ Individualized Instruction ______Convenient Location _ Recommended by Friend/Family _ _ _ _ _ Academic Reputation _ Personal Growth ______Faculty – Education Facilitators _ Educational Model ______PERSONAL_ ESSAY GUIDELINES ______Please_ answer the following questions (350 words minimum)._ You must type your _ _ response_ and be sure to include relevant details. ______1)_ Why are you pursuing a master’s degree (in TESOL_ or Human Services) with _ _ _ Boricua College? ______2)_ What are the most critical issues in your field _today? ______3)_ Describe how your professional life influenced_ your decision to attend graduate _ _ _ school. ______Please_ sign and date your essay. ______EDUCATIONAL STATEMENT (Please read and sign)

I understand that Boricua College reserves the right to refuse admission and matriculation to any applicant who, in the College’s judgment is not qualifies. Boricua College reserves the right to require withdrawal of any student, at any time, for any reason deemed sufficient under the rules and traditional practices of the College.

______Signature of Applicant Date of Application

APPLICATION CHECKLIST

Completed Application (The application cannot be processed if questions

are left unanswered) M

a 350 Word Personal Essay (Typed) n

h A $100.00 non-refundable fee is required to process this application a (money orders only) t

t College Degree (Bachelors) a

n Official College Transcript (If foreign degree, must be translated by GLOBE

or WES) C

a Valid Government Issue ID m

p Social Security Card and/or Alien Registration Card (If applicable) u

s Admissions Interview

B Proof of Income r

o Immunization Record (Measles, Mumps and Rubella) n

x Meningitis Response Form Completed

C Resume and Cover Letter a

m Please mail your application or drop it off in person to the location of your choice:p u Manhattan Campus Bronx Campus Center Brooklyn Campus Center s 3755 Broadway 890 Washington Avenue 9 Graham Ave New York, NY 10032 Bronx, NY 10451 Brooklyn, NY 11206 C 212-694-1000 347-964-8600 718-963-4112 [email protected] [email protected] [email protected] n t e r

B Admissions Interview

Interview Date ___ / ___ / ___ Faculty Recommendation No Yes _ _ Faculty Signature: ______Results: _ _

_ _ English Oral High Medium Low ______Conceptual _ High _ Medium _ Low ______Affective _ High _ Medium _ Low _ _ _ _ _ Clarity of Values High Medium _Low ______Comments: ______Recruiter: ______