Online Graduate School Application

Part A: Student Information
First Name: *
Last Name: *
Middle Name:
Maiden Name:
Current Street Address (Line1): *
Street Address (Line2):
City: *
County: *
State: *
Zip: *
Permanent Address:
Street Address (Line1): *
Street Address (Line2):
City: *
County: *
State: *
Zip: *
Email Address: *
Home Phone Number:
Work Phone Number
Fax Number:
Date of Birth (MM/DD/YYYY): *  
Where have you lived during the past twelve months? (give dates)
Are you a veteran?
Are you a current military service member?
Are you a spouse or child of a current or former service member?
Are you a United States citizen?
Have you ever been charged with a crime which would prevent your licensure
or certification as an educator, administrator or counselor?
Part B: Educational Background
Name of High School: *
Graduation Date(MM/YYYY): *  
Street Address and State of High School: *
University granting Bachelor's Degree: *
Degree: *
Date Received(MM/YYYY): *  
Major: *
University granting Master’s degree:
Date Received(MM/YYYY):  
List all colleges/universities attended (where you enrolled for graduate courses) since receiving your bachelor's degree. (Failure to do so may result in dismissal):
School Name      City/State     Term/Years Attended     Degree Received
Have you ever been dismissed from any college?

If so, when and for what reason?
Have you previously taken Northern’s correspondence, extension, or workshop courses?
If so, when(MM/YYYY):  
Have you ever applied for admission to another graduate school?
If yes, what college?
Were you admitted?
If you began a degree program and discontinued graduate study, state reasons for discontinuing:
Part C: Occupational Data
Have you gained certification by completing a teacher education program?

Do you have a valid teaching certificate?
If yes, specify state?
Beginning with latest date, list experience for the past five years:
Title of Position     Date     Place
Part D: Professional Objective
How did you learn about Northern?
Are you planning on working on a master's degree at Northern?
  • Master of Science in Education

    • (Check One)
  • Master of Science
  • Master of Music Education
  • Non - Degree

You have to choose a Major.
What year do you plan to begin Graduate Study? *
What semester do you plan to begin?
Application Agreement: I hereby certify that the information on this application is accurate in every respect and I understand that any intentional misrepresentation may be cause for revocation of admission. I also certify that I will inform the Office of Graduate Studies of any change in the above record which occurs between now and the opening date of the term for which I am applying. I agree to comply with the regulations and requirements of Northern State University and to cooperate with the authorities and any fellow students to maintain high standards of conduct and scholarship. It is understood that I accept registration as a student at Northern State University subject to the above provisions. Enrollment in classes offered through extension is open to all qualified students without official admission to the university or a college program, but enrollment by this method does not constitute admission.
Check this box to agree to the Application Agreement in the prior paragraph. Please Check The Checkbox
Reminder: PROVIDE 2 LETTERS OF RECOMMENDATION (3 IF APPLYING FOR A GRADUATE ASSISTANTSHIP). REQUEST ONE OFFICIAL COPY OF YOUR TRANSCRIPT TO BE SENT TO THE OFFICE OF GRADUATE STUDIES. A $35.00 NON-REFUNDABLE MATRICULATION FEE MUST BE PAID BEFORE ADMISSION CAN BE CONSIDERED. Please return to the Office of Graduate Studies, NSU, 1200 S Jay Street, Aberdeen, SD 57401. Northern State University is an equal opportunity institution. The policy of Northern State University is to provide equal opportunities for employment, admissions, and services to all individuals. Contact the affirmative action office on campus in the Administration Building, Room 213. Phone 605-626-2520.
Marital Status: *
Gender: *
Are you Hispanic or Latino?
Check one or more of the following races:

Print this page for your record before submitting
For Office Use Only
Application Fee:________________
GPA Cum:_____________________
GPA Last 64 Sem:_______________
GPA in Major:__________________
Approved: Degree______________
Senior Prov. Accpt:______________
Not Approved:_________________
Adm. Officer:__________________