Graduate Non-Degree Application and Registration Form : University of Dayton, Ohio

Graduate Non-Degree Application and Registration Form

To be considered for the graduate non-degree program, complete all required sections, and submit the form.

First Name

Middle Name

Last Name

Former name (if applicable)

Date of birth

Female

Male

Gender

Permanent mailing address

City

State

Zip code

Phone number

Email address

Country of birth

Yes

Are you a U.S. citizen or permanent resident?

If no, what is your citizenship?

Type of visa (if applicable)

Employer

Work phone number

Not married

Married

Marital status (optional)

No preference

Other

Protestant

Jewish

Catholic

Religious Preference (optional)

Other

White, non-Hispanic

Hispanic

Black, non-Hispanic

Asian or Pacific Islander

American Indian or Alaskan Native

Ethnicity (optional)

Previously Attended Colleges, Dates Enrolled and Credits Earned

Yes

Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in disciplinary action?

If yes, please provide details that give the approximate date of each incident and explains the circumstances.

Yes

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony? Note that you are not required to answer this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

If yes, please provide details that give the approximate date of each incident and explains the circumstances.

Term and Year You Would Like to Enroll

Subject, Number and Section of Course(s) You Want to Take

Submit

Professional and Continuing Education

Graduate Non-Degree Application and Registration Form

Office of Recruitment and Admission

Office of Recruitment and Admission