Program for Humanities Development

Student Application Information Form

All fields marked (REQ) will have to contain information before you will be able to mark application as complete.

Personal Information

Name: First Name (REQ):
Last Name (REQ):
Student Email (REQ): (email at current school)

School / Institution Contact Information:

Institution Name (REQ):
Address (REQ):

City (REQ):
ST (REQ): Zip Code (REQ):
Phone (REQ): (ie 614-123-4567)

Permanent Address Information:

Permanent Address (REQ):

City (REQ):
ST (REQ): Zip Code (REQ):
Phone (REQ): (ie 614-123-4567)

Additional Information

Rank (REQ): GPA (REQ):

Major (REQ):

2nd Major:

Minor :

2nd Minor:

Gender (REQ): Female Male
Ethnicity (REQ):

If Other selected, then explain:

Are you a US Citizen (REQ): Yes No

Statement of Purpose

In the Statement of Purpose, describe your research interest in the Humanities. Also, discuss your future career goals and your reason for pursuing a PhD. (NOTE: Please do not use quotes (') or double-quotes (") in your statement.)

Why are you applying for this program? (REQ) (500 word maximum)

Personal Statement

Use the Personal Statement to describe your ongoing involvement with and investment in historically under-represented communities. (NOTE: Please do not use quotes (') or double-quotes (") in your statement.)

Please enter your personal statement. (REQ) (500 word maximum)

Resume (REQ)

Please enter a Resume in Word .doc or Adobe .pdf file format

References

Who is submitting a letter of reference on your behalf? At least one of the following references must come from a college level instructor who knows you and your work well.
Reference #1

First Name (REQ): Last Name (REQ):
Email (REQ): (name@connection.com)
Phone (REQ): (ie 614-123-4567)
Relationship To Applicant (REQ):

Institution Information

Institution Name (REQ):
Address (REQ):

City (REQ):
ST (REQ): Zip Code (REQ):

Reference #2

First Name (REQ): Last Name (REQ):
Email (REQ): (name@connection.com)
Phone (REQ): (ie 614-123-4567)
Relationship To Applicant (REQ):

Institution Information

Institution Name (REQ):
Address (REQ):

City (REQ):
ST (REQ): Zip Code (REQ):

Transcript Information

Who will provide your official transcript? Provide below, the contact information for your institutions registrar, who will give us a copy of your most current official transcript?

First Name (REQ): Last Name (REQ):
Email (REQ): (name@connection.com)
Phone (REQ): (ie 614-123-4567)

Institution Information

Institution Name (REQ):
Address (REQ):

City (REQ):
ST (REQ): Zip Code (REQ):