California University of Pennsylvania Application for Admission School of Graduate Studies and Research 250 University Avenue California, PA 15419 Phone: 724-938-4187 Fax: 724-938-5712 E-mail: gradschool@cup.edu www.cup.edu
California University School of Graduate Studies Codes Areas of Specialization California University of Pennsylvania offers graduate work in the following areas of specialization: Master of Education 0115 Elementary Education (with cert.) 0118 Elementary Education (w/o cert.) 0119 Elementary/Special Education Dual Certification 0143 Mentally/Physically Handicapped 0150 Reading Specialist 0151 School Counseling Master of Arts Teaching 0501 English* 0521 Art* 0525 Communications* 0530 Physics* 0533 French* 0540 Spanish* 0548 Math * 0560 Biology* 0563 Earth Science* 0580 Social Studies* 0590 Chemistry* * For persons seeking INITIAL CERTIFICATION Master of Social Work 0350 Master of Social Work 0800 Non-Degree For those students who are not in a degree program or wish to take courses for personal Enrichment, permanent certification, master s Equivalency or for transfer. Master of Science 0330 Athletic Training 0325 Business Admin 0303 Communication Disorders 0320 Community and Agency Counseling 0310 School Psychology Certification Programs 0415 Elementary Education 0443 Mentally/Physically Handicapped 0157 School Counseling 0910 Reading 0410 School Psychology Post Mater s Certification 0701 School Counseling Certificate 0444 Autism Spectrum Disorders Cal U Global Online Master of Arts Teaching 0975 Advanced studies in Sec. Ed. (certified teachers only) Master of Science Legal Studies 0953 Homeland Security 0955 Law and Public Policy 0957 Criminal Justice Exercise Science and Health Promotion 0952 Wellness & Fitness 0954 Perform. Enhance. & Injury Prevention 0956 Rehabilitation Sciences 0958 Sport Psychology Sport Management 0962 Intercollegiate Athletic Admin. 0963 Sport Management Generalist 0964 Sports Counseling Masters of Ed. In Elementary Ed. 0902 National Board Teacher Cert 0903 Early Childhood Education 0904 Eng. as a Sec. Lang Certificate 0455 Superintendent s Letter of Eligibility Post Master s Certificate Exercise Science 0992 Wellness & Fitness 0994 Performance Enhancement and Injury Prevention 0996 Rehabilitation Science 0998 Sport Psychology Post Bachelor s Certificate Sport Management 0981 Intercollegiate Athletic Administration 0935 Sports Counseling Tourism Planning & Development 0925 Tourism Planning & Development Masters Science in Nursing 0930 Nursing Admin. & Leadership Master of Education 0976 K-12 Principal-Online 0915 Technology Education Certification Programs Online 0977 K-12 Principal Certificate 0911 Early Childhood Ed. Cert.
California University School of Graduate Studies Codes Present Military Status Ethnicity Race Codes 1 Non-Veteran H-Hispanic/Latino 2 Active Reserve A person of Cuban, 3 Inactive Reserve Mexican, Puerto Rican, 4 Duty Completed South or Central Amer., 5 Active Duty or other Spanish culture Or origin, regardless of race. N-Not Hispanic/Latino 2 Alaskan Native/American Indian A person having origins in any of the original Peoples of North & South America (including Central America), And who maintains tribal affiliation or community attachment. 3 Asian A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including for example, Cambodia, China, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam 4 Black/African American A person having origins in any of the black racial groups of Africa 5 Native Hawaiian/Pacifica Islander A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands 6 White A person having origins in any of the original peoples of Europe, the Middle East, or North Africa LIST OF PENNSYLVANIA COUNTIES BY CODE 01 Adams 09 Bucks 17 Clearfield 25 Erie 33 Jefferson 41 Lycoming 49 Northumberland 57 Sullivan 65 Westmoreland 02 Allegheny 10 Butler 18 Clinton 26 Fayette 34 Juniata 42 McKean 50 Perry 58 Susquehanna 66 Wyoming 03 Armstrong 11 Cambria 19 Columbia 27 Forest 35 Lackawanna 43 Mercer 51 Philadelphia 59 Tioga 67 York 04 Beaver 12 Cameron 20 Crawford 28 Franklin 36 Lancaster 44 Mifflin 52 Pike 60 Union 98 Foreign 05 Bedford 13 Carbon 21 Cumberland 29 Fulton 37 Lawrence 45 Monroe 53 Potter 61 Venango 99 Out-of-State 06 Berks 14 Centre 22 Dauphin 30 Greene 38 Lebanon 46 Montgomery 54 Schuylkill 62 Warren 07 Blair 15 Chester 23 Delaware 31 Huntingdon 39 Lehigh 47 Montour 55 Snyder 63 Washington 08 Bradford 16 Clarion 24 Elk 32 Indiana 40 Luzerne 48 Northampton 56 Somerset 64 Wayne
School of Graduate Studies and Research California University of Pennsylvania 250 University Avenue California, PA 15419-1394 Phone 724-938-4187 Fax: 724-938-5712 E-mail: gradschool@cup.edu Application for Admission to the School of Graduate Studies and Research 1. This form must be completed by all who expect to enroll in graduate studies at California University of Pennsylvania. 2. A nonrefundable $25 application fee must accompany this form. (Checks should be payable to California University of Pennsylvania.) 3. Official transcripts from all colleges and universities are required. Transcripts from California University of Pennsylvania are not required. 4. Incomplete applications will not be processed. *Indicates optional information Name Social Security Number Last First Middle Maiden Name Temporary Address Street City State Zip Residence Dates From: To: Permanent Address Street City State Zip E-mail address County (see code sheet) Country Home Phone Work Phone Sex* Male Female Race* (see code sheet) Ethnicity* (see code sheet) D/O/B Military Service Yes No If yes, present status (see code sheet) U.S. Citizen Yes No Legal Resident of PA Yes No Which location will you primarily attend? California Southpointe Other (indicate location) RET CaluGO Curriculum in which you desire to enroll (see code sheet) M.A.T. (Must have passed Praxis I) M.Ed. M.A. M.S. M.S.W. Post-Masters Certification Only Non-Degree Special Workshops Semester you plan to enroll Fall Spring Summer Year Have you been expelled or dismissed from a college or university? Yes No If yes, please explain on a separate sheet of paper.
Services for Students with Disabilities: The Office for Students with Disabilities provides services to students with disabilities. Call 724-938-5781 for information about application procedures, services and required documentation. Students are encouraged to contact the Office for Students with Disabilities prior to arriving on campus. I understand that the above statements are true to the best of my knowledge. Any false information may be used as grounds for denial or dismissal. I also realize that credentials filed in support of this application become the final property of California University of Pennsylvania. Signature Date Have you attended graduate school previously? Where? Number of credits earned Purpose of graduate study at Cal U Permanent Certification Transfer Purposes Degree Master s Equivalent Other Type of teaching certificate held Date issued Issued by what state Undergraduate Study Colleges or Universities Name and Location Dates Attended Course Taken/Major/Minor Degree Month & Year Graduate Study Colleges or Universities NOTE: If you do not register within one year of acceptance, you must reapply. In order to finalize your graduate application, you must put an X in ONE of the boxes below. I certify that I will not be enrolled in another program of study at another institution(s) while enrolled in a graduate program of study at California University of PA. I certify that I will be enrolled in another program of study at another institution(s) while enrolled in a graduate program of study at California University. In addition, I acknowledge that I will not be eligible for federal financial aid at California University of PA if I receive federal financial aid from the other institution(s). I understand that if California University discovers at a later date that I am receiving aid at another institution while receiving federal financial aid at California University of PA, my federal financial aid at California University of PA will be cancelled immediately and I will be liable for repayment of those federal aid funds I received. Lastly, I understand that failure to repay those dollars within 30 days will result in the University referring my account to the federal government for collection. NONDISCRIMINATION POLICY California University of Pennsylvania is an academic community dedicated to the ideals of justice, fairness and equal opportunity for all. In compliance with federal and state laws, the university is committed to providing equal educational and employment opportunities for all persons without regard to race, color, sex, religion, national origin, age, disability, ancestry, sexual orientation, or status as a disabled or Vietnam-era veteran. The university will not tolerate racial, ethnic or sexual discrimination. Sexual harassment is considered by law to be a form of sexual discrimination and is, therefore, unacceptable. Direct equal opportunity and affirmative action inquires or complaints to the Special Assistant to the President for EEEO/University Ombudsperson, Office of Social Equity, South Hall 112, 724-938-4014. Direct inquiries regarding services or facilities accessibility to the ADA/504 Compliance Officer, Office for Students with Disabilities, Residence Hall B, 724-938-5781. Direct Title IX inquiries to the Senior Women s Administrator/Title IX Coordinator, Department of Athletics, Hamer Hall 248, 724-938-4351.