GRADUATE ADMISSIONS APPLICATION

GRADUATE ADMISSIONS APPLICATION

Graduate Application SOUTHERN ADVENTIST UNIVERSITY Southern Adventist University is a private, Christian university. In a manner consistent with all applicable laws and regulations, it is open to all and does not discriminate on the basis of age, gender, race, color, ethnic or national origin, or disability in the administration of its educational policies, programs, and activities including its admissions policies, financial programs, and other university-administered programs. (OFFICE USE ONLY) ID Amount Receipt PERSONAL INFORMATION Please Print clearly Last/Family name Middle name First name Maiden Home address City State Zip code Country Home telephone ( ) Work telephone ( ) Cell phone ( ) Email U.S. Social Security Number (if applicable) Have you ever been convicted of a misdemeanor or felony?!"no!"yes If the answer is yes, please explain FOR NON-U.S. CITIZENS ONLY Country of birth Permanent resident # (a photocopy of your green card or visa must accompany this application) Citizenship Alien visa (type) FOR STATISTICAL PURPOSES Your disclosure/non-disclosure of the information below will not affect your eligibility for admission. The federal government requests that we collect this data for statistical purposes. Birth date (m/d/y) Gender!"Male! Female Marital status!"single!"married Ethnic origin!"black/african American!"American Indian/Alaskan Native!"Asian!"Hispanic/Latino "!"White!"Native Hawaiian/Other Pacific Islander!"Two or more races!"race and ethnicity unknown Religious affiliation Church (if SDA) Conference (if SDA) Union (if SDA) PROGRAM DATA For which degree are you applying? (Please note specific program and concentration/emphasis, list attached)! MA! MS! MBA! MFM! MSA! MMin!"MSN! RN-MSN! MSN/MBA! MSEd! MSW Concentration/Emphasis!"Full-time student! Part-time student Anticipated location of enrollment (check all that apply)! On-campus! Off-campus!"Online Anticipated term of enrollment! Summer (May/June) 20! Fall (Aug) 20!"Winter (Jan) 20

EDUCATIONAL HISTORY Have you previously attended Southern Adventist University?!"no!"yes Degree received and date Student ID# (if any) Please list all colleges and universities you have attended and degree conferred. Degree and major completed Degree and major completed Degree and Major completed Degree and Major completed Other names(s) under which transcript may be issued PROFESSIONAL HISTORY Please include present or most recent positions or jobs held. If you prefer, you may submit your current resume (use an additional sheet if needed). Employing organization Employing organization Title or office Title or office Location Location Dates from (m/y) Dates from (m/y) REFERENCES Please provide two references: Name Position Address Phone Name Position Address Phone How did you hear about Southern?! Radio! Website! Billboard! Ads!"Personal Contact! Other

INSTRUCTIONS In order for this application to be complete, the following must be sent to Graduate Studies at Southern Adventist University. Refer to the Graduate Catalog for additional admission prerequisites. Official transcripts of undergraduate degree course work Two recommendations; three for the Counseling emphasis (forms provided) $25 application fee (nonrefundable) GRE or GMAT score (as required by your program) TOEFL score (required of international students whose first language is not English) School of Business and Management only Essay of 250 words or less describing a) reason for enrolling in the program, b) what the program will enable you to do professionally. If you have not taken accounting, business, and finance, you must take appropriate courses or take a waiver exam. School of Nursing only Essay of 250 words or less describing a) your academic and professional goals, b) expectations of the program, c) any related talents, skills, collegiate and/or professional accomplishments, community activities, or other personal achievements. Tennessee RN license # Expiration date Have you been convicted of a crime other than a minor traffic violation?! yes! no Have you been on probation, suspended, or dismissed from any school?! yes! no If the answer is yes to either of the above, please explain School of Religion only If a pastor, what year did you enter the ministry? Are you an ordained minister?! yes! no If yes, date of ordination? Are you conference sponsored?! yes! no If yes, what conference? APPLICATION DEADLINES Fall semester - July 1 Winter semester - November 1 Summer term - April 1 School of Nursing Fall Semester - May 1 Winter Semester - October 1 DISABILITY SERVICES Students with physical or academic disabilities that could impact their learning experiences, who qualify for accommodations or special services, must contact the Learning Success Center at 423.236.2868. Southern is in compliance with Section 504 of the Rehabilitation Act (1973) and is dedicated to the elimination of architectural and prejudicial barriers which prevent any qualified person from attending. PLEDGE I voluntarily agree to uphold the ideals, standards, and principles set forth in the Southern Adventist University Graduate Catalog and Student Handbook and pledge my cooperation and loyalty. Since Southern is a Seventh-day Adventist institution, I understand that the values and standards of the church are reflected in the university rules and regulations. By registering at Southern Adventist University, students authorize the use and reproduction by the university, or anyone authorized by the university, of any pictorial images taken of them while enrolled at Southern, without compensation. All negatives, positives, and prints shall constitute Southern Adventist University property, solely and completely. I also understand that my signature below indicates that all the information given in this application is factually correct and honestly presented. Signature Date Print your full name Mail this graduate application form to: Graduate Studies, Southern Adventist University, Post Office Box 370, Collegedale, TN 37315-0370, USA Phone: 1.800.SOUTHERN Fax: 423.236.1694 Email: graduatestudies@southern.edu Web: graduatestudies.southern.edu

Graduate Programs and Concentrations SOUTHERN ADVENTIST UNIVERSITY Use this list of degrees and emphases offered by Southern to select your area of study as requested under the section Program Data on the graduate application form. Master of Business Administration (MBA) Accounting Church and Non-Profit Leadership Healthcare Administration (on campus, online) Human Resource Management Management (on campus, online, chattanooga) Marketing Management Master of Financial Services (MFS) Master of Science in Administration (MSA) Church Administration Customized Leadership Outdoor Education Master of Science (MS) Clinical Mental Health Counseling School Counseling Master of Science in Education (MSEd) Inclusive Education (hybrid) Instructional Leadership Literacy Education (hybrid) Outdoor Teacher Education Master of Science in Nursing (MSN) Adult Nurse Practitioner Family Nurse Practitioner Nurse Educator RN to MSN Accelerated Program (RN-MSN) Adult Nurse Practitioner Family Nurse Practitioner Nurse Educator Master of Science in Nursing/Master of Business Administration Post-Master s Certification Adult Nurse Practitioner Family Nurse Practitioner Nurse Educator Master of Ministry (MMin) Church Leadership and Management Church Ministry and Homiletics Evangelism and World Mission Master of Arts in Religion (MA) Biblical and Theological Studies Religious Studies Master of Social Work (MSW)* Child and Family Advocacy and Treatment International Social Work Marital Therapy and Stability Trauma and Emergency Response Older Adult Enrichment *Pending the approval of The Southern Association of Colleges and Schools (SACS), and the Council on Social Work Education, Southern is set to offer a new Master of Social Work degree by Fall 2010. Master of Science in Nursing/Master of Business Administration (MSN/MBA)

Graduate Recommendation SOUTHERN ADVENTIST UNIVERSITY Check the school to which you are applying: BUSINESS NURSING SOCIAL WORK EDUCATION/PSYCHOLOGY RELIGION PART I TO BE COMPLETED BY APPLICANT (print name of applicant) is applying for admission to the graduate studies program at Southern Adventist University. The applicant is asked to identify individuals who can provide information to the graduate studies council to assist in the admission process for the applicant. Under the provision of the Federal Family Educational Rights and Privacy Act of 1974 (must check one): I (applicant) retain the right to review this form I (applicant) waive my right to review this form Applicant's Signature Date PART II TO BE COMPLETED BY APPRAISER Applicant is requesting admission to Southern Adventist University and has given your name as a reference. We value your comments and ask that you give a full and candid report so that fair consideration may be given the applicant. We therefore ask for careful ratings and comments about the applicant s character and ability. An incomplete report may lessen the applicant's chances of admission. What is or has been your relationship with the applicant? How long have you known the applicant? SUPERIOR EXCELLENT VERY GOOD GOOD FAIR LACK (UPPER 5%) (UPPER 10%) (UPPER 25%) (UPPER 40%) (LOWER 50%) INFORMATION Intellectual ability Written expression Analytical thinking Oral communication Motivation/perseverance Interpersonal relations Commitment to service Integrity Emotional stability RECOMMENDATION IN HIGHEST HIGHLY RECOMMENDED RECOMMENDED NOT CONSIDERATION OF: RECOMMENDATION RECOMMENDED WITH CONFIDENCE WITH RESERVATIONS RECOMMENDED Academic qualifications Nonacademic qualifications Comments: (Additional comments can be submitted on a separate sheet) Signature Title Print Name Date Telephone ( ) Email