LIU Post APPLICATION FOR GRADUATE PERSONAL ENRICHMENT STUDENTS 720 NORTHERN BOULEVARD • BROOKVILLE, NEW YORK 11548 PHONE (516) 299-2900 • FAX (516) 299-2137

Students who hold a bachelor’s degree and wish to take a limited number of undergraduate or graduate level courses may be admitted as Personal Enrichment Students (non-matriculated). Acceptance as a Personal Enrichment Student does not constitute acceptance into a degree or certificate program. Complete the following application and mail, fax or deliver in person to the Office of Admissions, LIU Post, 720 Northern Boulevard, Brookville, NY 11548-1300; Fax 516-299-2137.

Name ______Last First MI

-- Student ID# Social Security No.

Other name your LIU record may be listed under______Last First MI

Mailing Address______City______State______ZIP______

______C heck here if your address has changed since you last attended LIU Date of Birth ______/ ______/ ______K Male K Female

Email address

Home Telephone______Work Phone______Cell Phone ______

Term Applying for: Fall 20______Spring 20______Summer 20 ______

COURSE NUMBER (AS LISTED IN SCHEDULE) CREDIT HOURS AUDIT DISCIPLINE COURSE SECTION

Have you previously applied to LIU Post? K Yes K No (If yes, when? Term______Year ______)

Are you currently an LIU Post student? K Yes K No

Have you ever been denied admission to LIU Post? K Yes K No (If yes, when? Term ______Year ______)

Do you hold a baccalaureate degree? K Yes K No Master’s degree? K Yes K No

List every college, university and other post-secondary school you have attended and degrees earned, beginning with the current school. College/University City State From-To Degree Received GPA

______

______

______

Have you ever been placed on disciplinary probation, been suspended or dismissed for disciplinary reasons from another academic institution? K Yes K No

Have you ever been charged with, convicted of, or plead guilty or no contest to a felony? K Yes K No

If you answered “yes” to any of the above questions, please attach an explanation. (Answering “yes” will not automatically prevent admission, but any falsification is grounds for denial or reversal of acceptance decision.)

The C.W. Post Campus of Long Island University is now LIU Post. A MAXIMUM OF NINE (9) CREDITS MAY BE TAKEN WITH PERSONAL ENRICHMENT STUDENT STATUS. THESE COURSES MAY BE TAKEN FOR CREDIT______OR ON AN AUDIT BASIS (NON-CREDIT)______.

I understand that this Personal Enrichment Application entitles me to take up to a total of nine credits and is not an official acceptance into a degree- granting program at LIU, and that as a Personal Enrichment student I am not eligible for financial aid and/or scholarship. I understand I must complete a Personal Enrichment application each semester prior to registration. To continue taking classes beyond the nine credits permitted as a Personal Enrichment student, I must apply for admission to LIU Post and submit all required credentials. I certify that all information provided is accurate and complete. I further understand that LIU Post reserves the right to amend or rescind any acceptance if it is discovered that I have withheld or falsified any information. Some programs require the signature of the advisor approving this course. Some of these include M.B.A., Accounting, Taxation, Speech-Language Pathology, Genetic Counseling, School Counseling, Clinical Mental Health Counseling and all Doctoral programs .

Signature ______Date ______

LIU does not discriminate on the basis of sex, handicap, race, national origin, religion or political belief in any of its educational programs and activities, including employment practices and its policies relating to recruitment and admission of students.

FOR OFFICE USE ONLY

A10 Std Admt ______Date ______

Dec Ltr ______Counselor: ______