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1 2083 Lawrenceville Road Lawrenceville, NJ T T

2 APPLICATION INSTRUCTIONS Applicants seeking a degree or certificate are asked to provide: 3 this application, including a $50 nonrefundable application fee (please make checks payable to Rider University); 3 official transcripts from every college or university attended; 3 official high school transcripts or official General Education Diploma (GED) if you have completed less than 30 cumulative credits at a college or university; 3 applicants for the Post-Baccalaureate Pre-medical, Pre-dental, and Pre-veterinary program must also complete a Post-Baccalaureate application, and submit a statement of aims/goals available in the College of Continuing Studies office (Bart Luedeke Center, Suite 31) or at under apply and register. Applicants who do not wish to pursue a degree are asked to provide: 3 this application, including a $50 nonrefundable application fee (please make checks payable to Rider University) 3 while official transcripts are not required, the College of Continuing Studies reserves the right to request transcripts on an individual basis. High School Students applying for admission as an undergraduate student or as part of the gifted and talented program are asked to contact to the Office of Admission at (609) or (800) for the appropriate application, or International Applicants are asked to contact the Office of Admission at (609) or (800) for the appropriate application or you may download the international student addendum at under international. All of the above applications can be found at Please indicate the semester and year in which you wish to begin undergraduate study: q Fall 20 q JTerm 20 q Spring 20 q Summer I 20 q Summer II 20 Please indicate how you would like to pursue your studies: q Part Time q Full Time

3 Part 1: PERSONAL INFORMATION (please print) q Mr. q Mrs. q Ms. q Miss q Dr. Name Last First Middle Former or maiden name Social Security Number Date of Birth (Month/Day/Year) Address Street City State Zip Code Country Home Phone ( ) Cell Phone ( ) Address Race/Ethnicity (optional): q African American q Caucasian q Hispanic q Asian q Native American q Other (please specify): Have you served in the U.S. Armed Forces or are you a spouse/dependent of same? q Yes q No Are you a U.S. citizen? q Yes q No If yes, please continue on to next page. If no, answer the five questions below: 1. Of what country are you a citizen? 2. Is English your native language? q Yes q No 3. What is your country of birth? 4. What is your Permanent Alien Registration Number? NOTE: If you are a permanent resident you must provide a copy of your alien registraion card (green card) with this application. 5. What is your immigration status? PLEASE NOTE: If you are seeking an F-1 visa, you must complete the International Student Addendum Part 2: PRIOR EDUCATION INFORMATION Have you applied to Rider before? q No q Yes If yes, please indicate when you applied If you have previously attended Rider, please indicate the college in which you were enrolled: q Continuing Studies q Business Administration q Liberal Arts, Education and Sciences q Westminster College of the Arts q Graduate School Education, Counseling, and Leadership q Graduate School Business Administration q Graduate School Liberal Arts Please include information on every high school and college/university attended: If you have attended any of these institutions under different names (former or maiden) please list those name(s) here: List honor(s) achieved at the above institutions: Are you a member of Phi Theta Kappa (PTK)? q Yes q No

4 Name of Institution City/State Year Graduated or Dates Attended High School/GED: College(s): Degree or Diploma Have you been dismissed from Rider or any other institution for poor scholarship or disciplinary reasons? q No q Yes* College *If yes, you must speak with a Continuing Studies advisor. Please call Year Part 3: EMPLOYER INFORMATION Name of Current Employer Street Address City State ZIP Code County Business Phone ( ) Address Job Title and Responsibilities Does your employer provide tuition benefits? q Yes q No Part 4: REFERRAL INFORMATION From what source did you hear about this program? Part 5: PROGRAM INFORMATION q Admission to an Undergraduate Degree Program (Please check Intended Degree Program below) Intended Degree Program: q BACHELOR OF SCIENCE IN BUSINESS ADMINISTRATION (Online degree completion program) q General Business q BACHELOR OF SCIENCE IN BUSINESS ADMINISTRATION q Accounting q Finance q Advertising q Human Resource Management q Business Administration q Management and Leadership q Computer Information Systems q Marketing q Entrepreneurial Studies q Undecided q BACHELOR OF SCIENCE IN NURSING (RN License required) q BACHELOR OF ARTS IN LIBERAL STUDIES Select a concentration from the following list: q Applied Social Science q Natural Science q Global Studies q Social Science q Humanities q Undecided q Law and Justice

5 q BACHELOR OF ARTS IN PSYCHOLOGY q BACHELOR OF ARTS IN PUBLIC RELATIONS q ASSOCIATE IN ARTS IN BUSINESS ADMINISTRATION q ASSOCIATE IN ARTS IN GENERAL STUDIES q Plan to pursue graduate study at Rider and would like to take pre-requisite courses. Please indicate which graduate program: q Permission to take courses as a Non-Matriculated Student and I may apply to a degree program in the future (Select an Intended Degree Program from above Year of anticipated matriculation ) q Admission to a Certificate or Post-Baccalaureate Program Select from the following list: q Public Relations q Business Forensics q Business Basics and Business Plus q Investment Analysis q Post-Baccalaureate Pre-medical, Pre-dental and Pre-veterinary Studies (must also complete the post-baccalaureate application and submit a statement of aims/goals) q Permission to enroll as a non-degree student (select this if you plan to take courses at Rider but do not intend to pursue a degree) q Permission to enroll as a visiting student (select this if you are a current student elsewhere and are in good academic standing) Part 6: DISCIPLINARY HISTORY 1. Have you been found responsible for a disciplinary violation at an educational institution you have attended, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? q Yes q No 2. Have you ever been convicted of a misdemeanor, felony, or other crime? q Yes q No If you answered yes to either or both questions, please attach a separate sheet of paper that gives the approximate date of each incident and explains the circumstances. I hereby apply for admission to Rider University and, if admitted, will uphold the standards and spirit of the Codes of Academic and Social Conduct.* I certify that my signature indicates I have reviewed and the application to be sure that all information is accurate. Any submission of inaccurate information during any part of the application process that the University believes is material or intentional may result in withdrawal of the offer of admission or dismissal from the University, without refund of any tuition or monies. Applicant s Signature Date Rider University encourages applications from all men and women whose achievements in either high school or college show evidence of their ability to successfully complete programs at the University. Rider University does not discriminate on the basis of race, color, creed, gender, age, sexual orientation, national or ethnic origin, or disability status in the administration of its educational or admission policies, employment practices, scholarship and loan programs, athletic programs and any other Ridersponsored program. * Codes of Academic and Social Conduct: The preamble to the Code of Academic Conduct includes the following statements: Academic honesty constitutes that cornerstone of the academic community. Rider University insists on strict adherence to the concept of academic honesty as indispensable to the continued existence and future development of the campus community. The Code of Social Conduct articulates guidelines for defining rights and responsibilities within the community. In order to function effectively and to provide a climate in which all members can fulfill their personal and community obligations, guidelines are enforced. The complete text of the code is in the Rider Source which is distributed by the Office of Campus Life to students at the beginning of each year. Rider expects all students to honor and maintain these codes. Rider University reserves the right to rescind admission for up to one year for any admitted student who violates the code of conduct prior to starting classes. For detailed information on Rider's code of conduct, please refer to The Source which is available online at

6 TO CONTACT US: Call (609) or (800) to speak with an Admission representative or schedule a visit to Rider s campus. College of Continuing Studies advisors are available anytime beforeand/or during the application process for academic advising, course selection, and unofficial transcript evaluation. Call (609) or to schedule an appointment. Office Use Only Application Fee Date Received Initials

Office of Graduate Admission 2083 Lawrenceville Road Lawrenceville, NJ 08648-3099 T 609-896-5036 www.rider.edu

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