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Admissions
Application for Graduate Enrollment
Instructions:
Answer all questions as completely and accurately as possible.
Before answering question #8, refer to  Curriculum Page for code information.
Important Documents and Information:
Required Documents and Curricula
Download Letter of Reference
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Personal Information
1. Social Security Number:
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2. Name:
Last Name:
First Name:
Middle Name:
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Previous Last Name:
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3. Permanent Address:
Street:
City:
State:
Zip:
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Telephone:
-
E-mail:
Preferred method of contact:
Phone
Email
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4. Employment:
Company Name:
Your Title:
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Address:
Street:
Floor or Suite:
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City:
State:
ZIP:
County:
Telephone: -
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E-mail:
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5. Check Appropriate Box
Male
Female
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6. Date of Birth: (MM/DD/YYYY)
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7. Citizen of:
If other than United States, please indicate visa/immigration status:
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8. In what program(s) of study do you expect to matriculate:
School of Arts & Sciences
School of Business
School of Education
(Please see Curriculum Page)
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Subject Name:
Code:
Certificate Area (If Applicable):
Code:
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Subject Name:
Code:
Certificate Area (If Applicable):
Code:
All new education students must meet with an education advisor prior to registering for class(es).
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9. Person to contact in case of emergency:
Name:
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Address: Street:
City:
State:
Zip:
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Home Telephone:
-
Business Telephone:
-
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10. Are you currently or have you ever been certified to teach in New York State?
If YES, please list area(s)
of certification (School of Arts and Sciences and School of Education Only)
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11. Ethnic Origin:
Response is voluntary and the information will be kept confidential. Refusal to provide this information will
not subject the applicant to any adverse treatment. The information is being collected for Dowling
College to comply with The Civil Rights Act of 1964 and will not be used in a discriminatory manner.
Black Non-Hispanic
Hispanic
Native American
White Non-Hispanic
Asian or Pacific Islander
Non Resident Alien
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12. If you are considering Education as a major, would you like to be considered as a candidate for the
Center for Minority Teaching Development and Training Program?
Yes
No
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13. Which campus will you be attending?
Rudolph Campus at Oakdale
Brookhaven Campus
Melville Center
Corporate Site
Teacher Center
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14. Colleges attended and dates of attendance:
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15. What special reason or person was responsible for your applying to Dowling College?
Dowling College Representative
Relative/Friend
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Trustee/Alumnus/Employee
Guidance Counselor
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Newspaper
Radio
Other
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16. Do you plan to file for Financial Aid?
Yes
No
If yes, has the free application for Federal Student Aid been filed with the Federal Government?
Yes
No
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17. Would you be interested in any of our accelerated programs for working adults?
Yes
No
18. What is your preferred means of communication?
E-mail
Telephone
NON-DISCRIMINATION POLICY: Dowling College complies fully with the provisions of the Civil Rights Act of 1964, with Title IX of the 1972 Educational
Amendments, the Age Discrimination Act of 1975, and with the Rehabilitation Act of 1973 in its policies on admission of students, educational programs and
activities and access thereto, and employment practices. Dowling College does not discriminate on the basis of race, color, religion, national origin, citizenship,
sex, sexual orientation, marital status, mental or physical disabilities, age, veteran/national guard or any other similarly protected status in its programs
and activities. The following person has been designated to handle inquiries regarding the non-discrimination policies: Ms. Ronnie MacDonald, Title IX Coordinator, Racanelli Center Room 209, Oakdale, NY 11769, 631.244.3362.
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