<p> Supplemental Application Humanities Master of Arts Program</p><p>DATE OF APPLICATION: SEMESTER START: SS# </p><p>I. GENERAL INFORMATION: (Please type or print)</p><p>______Last Name First Name Middle</p><p>______Mailing Address</p><p>______City Zip</p><p>Telephone Number: Home: ( ) Work: ( ) </p><p>Email address: ______</p><p>Occupation/Position/Dates: ______</p><p>II. ACADEMIC BACKGROUND:</p><p>Graduate of ______Major/Minor:______</p><p>Degree______GPA______Date______</p><p>List (up to six) upper division undergraduate courses in Humanities (Such as: History, Literature, Art History, Music History, Philosophy, Cultural Studies, Performance, and Film Studies) and years completed:</p><p>______</p><p>______</p><p>CSUDH Graduates Only: Date and score of GWE or equivalent (English 350) (Note: All HUM MA students who have not taken GWE must do so no later than completion of the first semester.)</p><p>III. AREAS OF INTEREST: (Rank numerically by interest) ( ) Art ( ) Literature ( ) Philosophy/Religious Studies ( ) Theater/Performance ( ) History ( ) Music ( ) Film Studies </p><p>IV. PERSONAL STATEMENT: Please attach a brief statement explaining your interest in the Humanities MA program and how it relates to your personal/professional goals. Include the following:  Undergraduate or other Humanities preparation  Why you are interested in this interdisciplinary program  Career goals and how this program will further them</p><p>V. LETTER OF REFERENCE: Please have a letter of support sent, preferably by an undergraduate instructor, to the address below. Name of recommender . Return this form and attached statement to: </p><p>Dr. Jim Jeffers, Program Coordinator, CSUDH, Humanities MA Program, LCH A338, 1000 E. Victoria Street, Carson CA 90747 Or return as an email attachment to [email protected]</p>