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Returning Student Form

 
Welcome back to VCSU! The form is to be used by graduate students who have previously attended VCSU and agree intending to return after having been out for more than one semester. You may send this form by mail directly to the Office of Graduate Studies, 101 College St SW, Valley City, ND 58072, email: graduate@vcsu.edu, or by fax to 701.845.7300. If you have attended any other college or university since attending VCSU, please have official transcript(s) sent to the address above. You do NOT pay an application fee. Failure to provide all of the information requested below may cause delays in processing and registration. Should you have any questions, please contact the Office of Graduate Studies at 701.845.7303.


PERSONAL DATA

1. Legal Name:
Last
First
MI
Former (if applicable)
2. Mailing Address:
Street and/or PO Box
City
State
County
Country
Zip Code
3. Gender:
4. Telephone: Home:
Area Code:  Phone: 
Cell:
Area Code: Phone:
5. Date of Birth: 6.Email Address:
7. Are you a North Dakota Resident? Yes   If yes, length of residency:
No    If no, state of residency
8. Admission status when withdrew from VCSU?:
9. Term you plan to return to VCSU:
Fall year
Spring year
Summer year
10. Please indicate intended education goal:
Earn Master of Education-Teaching and Technology
Earn Master of Education-Technology Education
Earn Master of Education-Technology Education plus North Dakota Licensure
Earn Master of Education-Library and Information Technologies
Earn Master of Education-English Language Learners
Non Degree:
*If you checked 'Non Degree', Enter the number of graduate course(s).:
Please read the following policy (# 6.3.c.):
No more than nine (9) credits taken under the non-degree status with a grade of B or higher can be transferred to any official program of study should there be, at any future date, a decision to seek degree classification.

EDUCATIONAL HISTORY
11. List in chronological order all colleges, universities, and other institution of higher education which you have attended or are attending.
Click 'Add College Attended' to enter more than one college, or 'Remove College Attended' to remove college from the list below.
  College/University State Dates Attended Major/Study Degree GPA
1

SIGNATURE

12. By submitting this document, I certify that all statements in this returning student application are complete and true.

*NOTE: This information is required for statistical purposes only and will not affect the status of your application. The information will not be used in a discriminatory manner and your response is voluntary.
**Disclosure of your Social Security Number is voluntary. Social Security Numbers are used as an individual ID number for record keeping and administrative purposes. Failure to provide a SSN may cause delays in administrative services such as financial aid processing.
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