<p> INDIANA STATE UNIVERSITY DEPARTMENT OF EDUCATIONAL LEADERSHIP, ADMINISTRATION, AND FOUNDATIONS</p><p>Ph.D. IN HIGHER EDUCATION PROGRAM APPLICATION [NOTE: Use TABS to fill the Application Form]</p><p>A. I have applied for admission to the School of Graduate Studies for <--select--> (Fall/Spring/Summer) (year).</p><p>B. I would like to be considered for admission to a cohort group for the academic year.</p><p>XX Leadership in Higher Education </p><p>C. Please attach writing sample as instructed on next page.</p><p>Student Name: </p><p>Date of Application: </p><p>Home Address: </p><p>City: State: Zip Code: </p><p>Birth date: </p><p>Home Telephone: Business Telephone: </p><p>Business Name: </p><p>Business Address: </p><p>Fax Number: E-mail Address: </p><p>Current Position(Briefly describe your professional experience):</p><p>Years in Current Position: </p><p>Highest Degree Earned(Briefly describe your academic experience):</p><p>Institution: </p><p>Academic Performance</p><p>Graduate Record Examination( Date taken): </p><p>Verbal: Quantitative: Analytical: </p><p>Graduate Grade Point Average: </p><p>At the end of this application, please submit a writing sample to be evaluated as part of the admission process. Your paper should respond to the following areas:</p><p>I. Work Experience Related to Educational Administration</p><p>A. Applicant must discuss in detail all professional work experience related to desired specialization, such discussion should include, but is not limited to: 1. Professional leadership positions held and an overview of responsibilities and accomplishments 2. Memberships, elected offices, honors or awards in professional organizations or honor societies or related to specialty area.</p><p>B. Applicant must discuss in detail all research and publication/presentation experience that relates to desired specialization. Such discussion should include, but is not limited to, competitive grants, and state or national publications and presentations.</p><p>C. Applicant must discuss in detail work activity pertinent to educational administration. Such discussion should include documentation of accomplishments in addition to, not embellishments of, information already provided.</p><p>II. Professional Goals Applicant should discuss in detail reasons for the pursuit of the desired specialization in educational administration and how this program will help you to achieve your goals.</p><p>Send application as an email attachment to: [email protected] Or You may mail the application to: Chairperson Department of Educational Leadership Indiana State University Bayh College of Education, 211G Terre Haute, IN 47809.</p>