Clarkson University. Applications Procedures

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1 Clarkson University M.S. In Engineering & Global Operations Management/Graduate Certificate Option Graduate Program Applications Procedures 1. A completed application form. 2. Three references (professional and/or academic), who can evaluate your work. Your references may submit letters in lieu of these forms. One reference must be from a manager or supervisor. 3. Official transcripts of your entire undergraduate course work. If your undergraduate work was done at Clarkson, we will request a copy of your transcripts from our Registrars Office. 4. Current resume word essay describing your objectives for pursing a graduate degree and how Clarkson s graduate and executive programs fit into your objective. Note: GMAT is not required for admission into this program. All entering students must have at least two years of industry experience and be nominated by their company. Please mail all your materials to: Nicole Wise Engineering & Global Operations Management Clarkson University Box 5740 Potsdam, NY 13699

2 GRADUATE SCHOOL APPLICATION FOR ADMISSION Name Mr. Ms. Miss Mrs. Date Family/Surname Given/First Name Middle Name Marital Status Single Married Divorced Preferred Name Date of birth (mm/dd/yy) / / Place of birth (city/state/country) / / Language spoken at home Optional Personal Data for U.S. Citizens Ethnicity: American Indian or Alaskan Native Black, non-hispanic Hispanic Asian or Pacific Islander Caucasian Other (please specify) Citizenship (check only ONE) Country of Citizenship U.S. Citizen Social Security Number U.S. Permanent Resident (attach copy of both sides of Resident Alien card) Registration Number Non-U.S. Citizen Current Visa Status (e.g. F-1, J-1, etc.) Refugee CURRENT MAILING ADDRESS Street Address/P.O. Box District/Province City State Country Zip Code Telephone No. Day ( ) Evening ( ) Effective Dates: From (mm/dd/yy) / / to (mm/dd/yy) / / PERMANENT HOME ADDRESS Street Address/P.O. Box District/Province City State Country Zip Code Telephone No. Day ( ) Evening ( ) E mail Address home campus other Fax Number First semester/year you wish to enroll: Fall (year) Spring (year) Summer (year). I hope to attend full time part time. Name of graduate area, school, and/or department in which study is planned (see list on back) Area(s) of specialization in which study is planned, if known (see enclosed list) Degree toward which study is directed MBA M.E. M.S. Ph.D. ME/MBA Student Number (if attended Clarkson previously) Former names (if applicable) How, where, or from whom did you learn about Clarkson? _ List all colleges or universities currently attended. Official transcripts or records at all higher educational institutions attended except Clarkson are required and must be sent to the appropriate Graduate Studies office indicated on the application procedures page. Institution Location Field of Study Dates Attended Degree (if any) to to to Grade-point average (undergraduate): Cumulative out of possible (i.e., 3.4/4.0, 75/100, etc.) Last semester out of possible AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EDUCATIONAL INSTITUTION

3 Professional or work experience: Dates Employer Location Title/Position Academic honors, prizes, or scholarships you have received or honor societies to which you have been elected: Professional organizations in which you hold membership: Title or description of any thesis, research report, patent, or other publications (use separate sheet if necessary): What is your career goal with respect to the graduate program? Letters of recommendation from three instructors or employers who can speak authoritatively regarding your aptitude and preparation for graduate study are required. Use the forms supplied for this purpose. On the following lines, list the names and addresses of the individuals from whom you have requested recommendations. If you are a Clarkson student, please list three faculty who know you and can evaluate your work GRADUATE AREAS AND DEGREES OFFERED School of Engineering Chemical (ME MS PhD) Civil & Environmental (ME MS PhD) Electrical and Computer (ME MS PhD) Mechanical (ME MS PhD) Interdisciplinary Engineering Science (MS PhD) School of Science Chemistry (MS PhD) Mathematics (MS PhD) Physics (MS PhD) Health Sciences (MS) School of Business Master of Business Administration (MBA) Management Systems (MS) Health Sciences Physical Therapy (DPT) Interdisciplinary Programs Computer Science (MS) Information Technology (MS) Engineering & Global Operations Management (MS for Working Professionals) Professional Management (MS for applicants in industry) Environmental Science & Engineering (MS PhD) Are you also interested in applying to graduate programs in other schools of Clarkson University? If so, please indicate your interest, and we will have information sent to you. Do you wish us to consider this as an application for admission regardless of whether you secure an assistantship? Yes No If you wish to apply for an assistantship, indicate preference by giving first and second choice Teaching Research If you wish to be considered for a teaching assistantship, have you had any prior experience in this capacity or a similar one? If yes, please attach a separate letter giving details. Yes No Specify any outside financial assistance available to you: _ Describe your background (e.g.; coursework, professional and research experience, etc.) as it relates to your areas of interest. I certify that the statements made in this application are true to the best of my knowledge. If admitted, I agree to abide by the rules and regulations of Clarkson. Signature of Applicant NOTE: This application and all correspondence concerning it should be sent to the appropriate graduate studies office indicated on the application procedures page. Full-time applicants to the graduate school from within the U.S. and Canada are required to pay a $25 application fee. All other full-time applicants are required to pay a $35 application fee. This fee cannot be waived or deferred except for applicants from within the U.S. and Canada who apply for admission before December 31 for the following fall semester, or June 30 for the following spring semester. Part-time, Engineering & Global Operations Management and Professional Management students are not required to pay an application fee.

4 CLARKSON UNIVERSITY ENGINEERING & GLOBAL OPERTATIONS MANAGEMENT GRADUATE PROGRAM REFERENCE FORM To be completed by Applicant (Please print in black ink): Applicant=s Name Date I dog do notg agree to waive my right under The Family Education Rights and Privacy Act of 1974 to review specific and composite letters of this recommendation. Applicant Signature To be completed by Referee: I have known the applicant for years; in what capacity Quality Superior Above Below Inadequate Opportunity to Observe Motivation Imagination Initiative Cooperativeness Dependability Maturity Perseverance Oral Expression Written Expression Analytical Ability Remarks (continue on separate page if necessary) Name Signature (Please Print) Company Position Return this form to Engineering & Global Operations Management, Clarkson University, Box 5740, Potsdam, NY An Equal Opportunity/Affirmative Action Education Institution

5 CLARKSON UNIVERSITY ENGINEERING & GLOBAL OPERATIONS MANAGEMENT GRADUATE PROGRAM REFERENCE FORM To be completed by Applicant (Please print in black ink): Applicant=s Name Date I dog do notg agree to waive my right under The Family Education Rights and Privacy Act of 1974 to review specific and composite letters of this recommendation. Applicant Signature To be completed by Referee: I have known the applicant for years; in what capacity Quality Superior Above Below Inadequate Opportunity to Observe Motivation Imagination Initiative Cooperativeness Dependability Maturity Perseverance Oral Expression Written Expression Analytical Ability Remarks (continue on separate page if necessary) Name Signature (Please Print) Company Position Return this form to Engineering & Global Operations Management, Clarkson University, Box 5740, Potsdam, NY An Equal Opportunity/Affirmative Action Education Institution

6 CLARKSON UNIVERSITY ENGINEERING & GLOBAL OPERATIONS MANAGEMENT GRADUATE PROGRAM REFERENCE FORM To be completed by Applicant (Please print in black ink): Applicant=s Name Date I dog do notg agree to waive my right under The Family Education Rights and Privacy Act of 1974 to review specific and composite letters of this recommendation. Applicant Signature To be completed by Referee: I have known the applicant for years; in what capacity Quality Superior Above Below Inadequate Opportunity to Observe Motivation Imagination Initiative Cooperativeness Dependability Maturity Perseverance Oral Expression Written Expression Analytical Ability Remarks (continue on separate page if necessary) Name Signature (Please Print) Company Position Return this form to Engineering & Global Operations Management, Clarkson University, Box 5740, Potsdam, NY An Equal Opportunity/Affirmative Action Education Institution

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