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					                                                                                              APPLICATION FOR GRADUATE ADMISSIONS
                                                                                                                for U.S. Citizens and Permanent Residents

                          Checklist for Graduate School Admissions                                                     College Contact Information
                          ☐    Application, completed in its entirety                                                  Agriculture & Life Sciences          540/231-6503
                                                                                                                          www.cals.vt.edu
                          ☐    In-state tuition request form (printed page 7), if applicable
                                                                                                                       Architecture & Urban Studies         540/231-6386
                          ☐    Official transcript(s) from all institutions where a degree                                www.caus.vt.edu
APPLICATION CHECKLIST




                               was received or graduate level work was taken.
                                                                                                                       Business (Pamplin)                   540/231-6152
                          ☐    Application fee (Please review and attach the                                              www.pamplin.vt.edu
                               Payment Processing Form, printed page 9.)
                                                                                                                       Engineering                          540/231-9171
                          ☐    Official test scores should be sent to Graduate                                            www.eng.vt.edu
                               School Admissions (ETS Institution Code: 5859)
                                                                                                                       Liberal Arts & Human Sciences        540/231-6779
                                                                                                                          www.clahs.vt.edu
                          Checklist for Your Department/Program
                                                                                                                       Natural Resources                    540/231-7051
                          ☐    Letters of recommendation (make sure to                                                    www.cnr.vt.edu
                               list each evaluator in the application)
                                                                                                                       Sciences                             540/231-5145
                          ☐    Official transcript(s) from all institutions where a degree                                 www.cos.vt.edu
                               was received or graduate level work was taken to the department
                                                                                                                       Biomedical & Veterinary Sciences     540/231-4992
                          ☐    Statement of Purpose                                                                       www.vetmed.vt.edu

                          ☐    Supplemental information                                                                Campuses Across Virginia
                          ☐    Test scores (GRE, GMAT, and/or TOEFL)                                                   Blacksburg (main campus)             540/231-8636
                                                                                                                           www.vt.edu
                          Check the website of the department for specific details on their requirements.
                                                                                                                       National Capital Region              703/538-8327
                          Test Scores                                                                                     www.ncr.vt.edu
                                                                                                                       Hampton Roads                   757/363-3930 x301
                          While we ask that you report your scores on this application, the                              www.hrc.vt.edu
                          official information must come from the respective testing agencies.
TEST SCORES




                          Applications are not considered complete until this information is                           Richmond                             804/662-7286
                          reported by the testing agencies.                                                               www.richmond.vt.edu

                               Educational Testing Services (ETS) Institution Code is 5859.                            Roanoke                              540/767-6100
                               Graduate Management Admissions Test (GMAT) Institution Codes are:                          www.roanoke.vt.edu
                               53B-XS-08 MBA, Full-time (Blacksburg)
                               53B-XS-06 PMBA, Full-time (Richmond/Roanoke)                                            Southwest Virginia                   276/619-4311
                               53B-XS-35 EMBA, Full-time (National Capital Region)                                        www.swcenter.vt.edu
                               53B-XS-97 MBA, Part-time (National Capital Region)
                               53B-XS-34 ACIS, (Blacksburg)                                                            Virtual Campus                       540/231-1264
                               53B-XS-59 PhD Programs (Blacksburg)                                                         www.vto.vt.edu


                          Financial Aid Information                                                                                          Application Deadlines
FINANCIAL AID




                          If you are a U.S. Citizen or Permanent Resident, you may want to                                            FALL                      July 1
                          consider financial aid opportunities. The Virginia Tech Office of                                           SPRING              December 1
                          University Scholarships and Financial Aid can provide information
                          about funding opportunities at www.finaid.vt.edu. You must file a Free                                      SUMMER 1                April 15
                          Application for Federal Student Aid (FAFSA) at                                                              SUMMER 2                  June 1
                          www.fafsa.ed.gov to be considered for this aid.
                                                                                                                             Send application and payment to:
                          Financial assistance may be available through the department to                                           Graduate School Admissions
                          which you are applying in the form of an assistantship (GTA/GRA) or                             Graduate Life Center at Donaldson Brown
                          fellowships. Check with your intended department for more information.                                               Virginia Tech (0325)
                                                                                                                                             Blacksburg, VA 24061
                          Virginia Tech does not discriminate against employees, students, or applicants
                          on the basis of race, color, sex, sexual orientation, disability, age, veteran status,                                      Fax: 540/231-2039
                          national origin, religion, or political affiliation. Anyone having questions concerning
                          discrimination or accessibility should contact the Office for Equal Opportunity.                               Questions? Call 540/231-8636 or
                                                                                                                                      e-mail gradappl@vt.edu for assistance.
                        GRADUATE APPLICATION FOR U.S. CITIZENS/PERMANENT RESIDENTS
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                                                                                                           APPLICATION FOR GRADUATE ADMISSIONS
                                                                                                                                 for U.S. Citizens and Permanent Residents



                 LAST/FAMILY NAME                                                                          FIRST/GIVEN NAME                                         MIDDLE NAME                         SUFFIX


                List any former names:
                                                                                                                                                 Enrollment Information

                                                                                                                                                 Term of Enrollment
                Social Security Number:                                                                                                          □ FALL □ SPRING □ SUMMER I
                                                                                                                                                                 □ SUMMER II                         year
                Providing your SSN is optional, but is required of enrolled students for federal tax reporting. If you intend to apply for
                financial aid and scholarships or be employed on-campus, your SSN must be submitted.
                                                                                                                                                 Campus

                Student ID Number (if applicable):                                                                                                  □   BLACKSBURG (MAIN)*
                                                                                                                                                    □   HAMPTON ROADS
                                                                                                                                                    □   NATIONAL CAPITAL REGION
                Current Mailing Address
                                                                                                                                                    □   RICHMOND
                                                                                                                                                    □   ROANOKE
                                                                                                                                                    □   SOUTHWEST VIRGINIA
GENERAL INFO




                                                                                                                                                    □   VIRTUAL
                                                                                                                                                   *Blacksburg should be selected if the campus at which
                                                                                                                                                    you intend to enroll is not listed. Provide details on the
                                                                                                                                                    supplemental form, page 3 of this application.

                 city                                                   state                        zip                         country
                                                                                                                                                 Degree Level
                       Current                                                                              Please list your primary                □ DOCTORAL
                Daytime Phone:                                                                              phone and e-mail. We                    □ EDUCATION SPECIALIST
                                                     □ Home □ Office □ Mobile
                       Current                                                                              value your privacy and                  □ MASTERS
                Evening Phone:                                                                               will not disclose your                 □ GRADUATE CERTIFICATE
                                                     □ Home □ Office □ Mobile                                     information.
                                                                                                                                                    □ NON-DEGREE
                E-mail Address:                                                                                                                     □ COMMONWEALTH CAMPUS


                                                                                                                                                 Desired Program


                Permanent/Home Country Address (if different):
                                                                                                                                                 Virginia Tech Undergraduates
                                                                                                                                                     who are applying to concurrently be in both
                                                                                                                                                     undergraduate and graduate status at the
                                                                                                                                                     same time, please indicate in which category
                                                                                                                                                     you will be applying:
                                                                                                                                                    □ 152 HR ACIS MASTERS DEGREE

                                                                                                                                                    □ BACHELORS/MASTERS DEGREE
                 city                                                   state                        zip                         country              (HONORS)

                                                                                                                                                    □ BACHELORS/MASTERS DEGREE (OPEN)
                Permanent Daytime Phone:
                                                                     □ Home □ Office □ Mobile                                                       □ DUAL STUDENT STATUS

                Permanent Evening Phone:                                                                                                            □ COMBINED STUDENT STATUS
                                                                    □ Home □ Office □ Mobile                                                          (ARCHITECTURE ONLY)




                                                                                                                                             Citizenship:
                 Personal Information                                              Please answer both of the following
PERSONAL INFO




                                                                                   questions:                                                ☐ U.S. Citizen
                 Gender: ☐ Male ☐ Female                                           Are you Hispanic, Latino, or of Spanish                   ☐ Permanent Resident (copy of PR Card required)
                                                                                   Origin ? ☐ Yes ☐ No
                 Date of Birth:             /        /       (MM/DD/YY)                                                                      US State of Legal Residence:
                                                                                   Please select your race: choose all that apply.
                 City of Birth:                                                                                                              Are you claiming entitlement to Virginia in-state
                                                                                   ☐ African American/Black
                                                                                                                                             tuition rates pursuant to Section 23.7-4, Code of
                 State of Birth:                                                   ☐ American Indian/Alaskan Native                          Virginia? ☐ No ☐ Yes If yes, you must complete the
                 Country of Birth:                                                 ☐ Asian                                                   Graduate In-State Tuition Request on page 7.

                 The U.S. Department of Education has                              ☐ Native Hawaiian/Pacific Islander
                 requested that we collect the following
                 information on race and ethnicity.                                ☐ White                                                                       Questions? Call 540/231-8636 or
                                                                                                                                                              e-mail gradappl@vt.edu for assistance.
                GRADUATE APPLICATION FOR U.S.CITIZENS/PERMANENT RESIDENTS
                PAGE 1 OF 3, JULY 2009
                                                                                             APPLICATION FOR GRADUATE ADMISSIONS
                                                                                                          for U.S. Citizens and Permanent Residents

                            Academic History
ACADEMIC HISTORY




                            In chronological order, beginning with the most recent, list any bachelor and/or graduate level work that you will have done prior to
                            enrollment. Note that official transcript(s) must be sent to the Graduate School and to the academic department to which you are applying.

                                               INSTITUTION NAME                         DEGREE TYPE           MAJOR               GPA      DATE RECEIVED/EXPECTED




                            Letters of Recommendation
                            Please make sure that your referees have indicated in advance that they are willing to submit a reference form for you. Please keep in
                            mind that it is your responsibility to ensure that your recommenders have submitted their forms by the appropriate deadline.
                            Under the Family Educational Rights and Privacy Act of 1974, a student enrolled at Virginia Tech has access to his or her academic
                            records. We comply with this law, while still allowing the student the option of waiving the right to access this specific document.
                            Waiving this right does not preclude you from access to the rest of your academic records. If you wish to waive the right to examine
                            this evaluation at a later date, please indicate below. Your choice will not affect the consideration of your application to Virginia Tech.
LETTERS OF RECOMMENDATION




                            First Reference                                                                                                     Do you waive your
                                                                                                                                                right to access this
                            TITLE     FIRST NAME                                          LAST NAME
                                                                                                                                                evaluation?
                                                                                                                                                ☐   Yes
                            INSTITUTION/COMPANY NAME
                                                                                                                                                ☐   No
                            Daytime Phone:                                                E-mail:




                            Second Reference                                                                                                    Do you waive your
                                                                                                                                                right to access this
                            TITLE     FIRST NAME                                          LAST NAME
                                                                                                                                                evaluation?
                                                                                                                                                ☐   Yes
                            INSTITUTION/COMPANY NAME
                                                                                                                                                ☐   No
                            Daytime Phone:                                                E-mail:




                            Third Reference                                                                                                     Do you waive your
                                                                                                                                                right to access this
                            TITLE     FIRST NAME                                          LAST NAME
                                                                                                                                                evaluation?
                                                                                                                                                ☐   Yes
                            INSTITUTION/COMPANY NAME
                                                                                                                                                ☐   No
                            Daytime Phone:                                                E-mail:



                            While we ask that you report your scores here, the official scoring information must come from the respective testing agencies.
TEST SCORES




                            GRE General Test                                 GRE Subject Test                              GMAT Score

                              Test Date:            /      (MM/YY)           Subject:                                      Test Date:       /        (MM/YY)

                              Verbal Score:                                  Test Date:             /   (MM/YY)            Test Score:
                              Quantitative Score:
                                                                             Test Score:
                              Analytical Writing Score:                                                                             Questions? Call 540/231-8636 or
                                                                                                                                 e-mail gradappl@vt.edu for assistance.
                            GRADUATE APPLICATION FOR U.S. CITIZENS/PERMANENT RESIDENTS
                            PAGE 2 OF 3, JULY 2009
                                                                                                               GENERAL SUPPLEMENTAL FORM


                   Prior to completing this form, check with the department to which you are applying to see if they require a more specific
                   supplemental form. Some departments have forms that replace this general one.

                   Name:                                                                                                Date of Birth:        /       /     (MM/DD/YY)
                   Degree Program:

                   Alternate Campus Location
                    If you wish to take classes at a location other than the Virginia Tech campuses listed on printed
                    page 1 of this application, please list below.




                   Academic and Professional Goals Statement
GOALS AND RESUME




                    Please attach a 3 to 4 page double-spaced personal statement which includes the following:


                       •   Why do you want to undertake graduate work?

                       •   What do you expect to derive from your program of study?

                       •   If you have a concentration in mind, briefly outline your interests in this area.

                       •   What do you expect to contribute as a student and, subsequently, as a member of the profession?

                   Resume
                    Applicants are asked to provide a resume outlining your most recent experiences or by listing those that are most relevant to your application.
FINANCIAL




                   Financial Assistance
                           Do you wish to be considered for an assistantship or fellowship?                                ☐ YES          ☐ NO

                           Will you be able to attend Virginia Tech without an assistantship or fellowship?                ☐ YES          ☐ NO




                   Pledge of Honor                                                                                                                Return your completed
                                                                                                                                                  Supplemental Form to:
SIGNATURE




                   I certify that all information provided to the Graduate School and department on my
                   application and during the entire admissions process is accurate. I understand that upon                               The department to which
                   admission and enrollment I will be subject to the rules and regulations of the university,                                    you are applying.
                                                                                                                                         Please visit your College’s website,
                   including the Graduate Honor System (http://ghs.grads.vt.edu).
                                                                                                                                                    listed on the cover sheet,
                                                                                                                                                      for contact information.


                   APPLICANT SIGNATURE                                                                     DATE

                                                                                                                                   Questions? Call 540/231-8636 or
                                                                                                                                e-mail gradappl@vt.edu for assistance.
                   GRADUATE APPLICATION FOR U.S. CITIZENS/PERMANENT RESIDENTS, GENERAL SUPPLEMENTAL
                   PAGE 3 OF 3, JULY 2009
                                                                                                            AdditionAl ReQuiRed infoRmAtion


                                  Additional Required information


                                         Have you been convicted of or received a juvenile adjudication for a violation of any local,    ☐ Yes    ☐ No
                                         state, or federal law, other than a minor traffic violation?


                                         Are you currently on court-ordered supervised or unsupervised probation or under the terms      ☐ Yes    ☐ No
                                         of a finding under advisement?


                                         Please give a full explanation of any past criminal convictions:
AdditionAl RequiRed infoRmAtion




                                                                                                                                        Return your completed form to:
                                                                                                                                           Graduate School Admissions
                                                                                                                                  Graduate Life Center at Donaldson Brown
                                                                                                                                                       Virginia Tech (0325)
                                                                                                                                                     Blacksburg, VA 24061
                                                                                                                                                           Fax: 540/231-2039

                                  ApplicANt sigNAture                                                          DAte




                                                                                                                                                Questions? Call 540/231-8636 or
                                                                                                                                             e-mail gradappl@vt.edu for assistance.
                                  AdditionAl RequiRed infoRmAtion
                                  PAge 1 of 1, oCtobeR 2008
                                                                                    GRADuAte In-StAte tuItIOn ReQueSt

                If you are being charged out-of-state tuition and believe you are eligible for in-state rates, please complete the
                following form. You must be a u. s. citizen; a permanent resident alien; or hold an A, e, G, H-1 or H-4, K, or N visa to
                establish residency that qualifies you for in-state tuition. Please attach a copy of your permanent resident alien card
                or I-94, visa stamp, and/or other uscIs approval notification. You must also demonstrate intent to establish domicile
                in Virginia. the university requires additional supporting documentation demonstrating your residency qualification
                for the prior year. Please include a copy of your Virginia state income taxes, driver’s license, vehicle registration,
                voter registration, and lease/mortgage agreement. failure to supply this information may result in the denial of your
                request. use the other side of this form to provide additional information to be considered on your application.


                 lAst/fAmIlY NAme                                             fIrst/GIVeN NAme                               mIddle NAme                suffIx

                Student ID number:                                             Citizenship
                                                       if known                □ u.s. cItIzeN      □ PermANeNt resIdeNt         □ NoN-resIdeNt AlIeN*
PersoNAl INfo




                Date of Birth:                                                 *If non-resident alien, please list your visa status:
                                                 month/day/year

                e-mail Address:                                                Current Program                                     Degree Level
                                             @vt.edu account, preferred
                                                                                                                                    □ doctorAl
                Daytime Phone:
                                           □ Home □ office □ mobile            First term of enrollment                             □ educAtIoN sPecIAlIst
                Local Address                                                  □ fAll □ sPrING □ summer I                           □ mAsters
                                                                                               □ summer II          year
                                                                                                                                    □ GrAduAte certIfIcAte
                                                                               Anticipated Completion term                          □ NoN-deGree
                                                                               □ fAll □ sPrING □ summer I
                                                                                               □ summer II                          □ commoNweAltH cAmPus
                                                                                                                    year
                                                                               Campus
                                                                               □ BlAcKsBurG □ HAmPtoN roAds □ NAtIoNAl cAPItAl reGIoN □ rIcHmoNd
                                                                               □ roANoKe □ soutHwest VIrGINIA □ VIrtuAl
                 city                         state      zip        country
                                                                                                     Beginning with the most recent, chronologically list the
                How long have you resided in Virginia?            Years:        Months:              addresses at which you have resided for the past two years.

                Prior Address 1:
                                   street address                                          city                  state               zip                 country

                Prior Address 2:
                                   street address                                          city                  state               zip                 country
                Do your parents/legal guardian/spouse provide over half of your financial support OR claim you
                as a dependent on their taxes?                                                                              □ Yes □ No
requIred INfo




                    If yes, in which state do your parents reside?                    (If VA, attach a copy of their VA state income taxes.)
                For the twelve months prior to the term in which you will enroll, will you have:
                    1. filed a tax return or paid income taxes to Virginia?                                                                □ Yes □ No

                    2. been a registered voter in Virginia?                                                                                □ Yes □ No

                    3. held a valid Virginia Driver’s license?                                                                             □ Yes □ No

                    4. owned or operated a vehicle?                                                                                        □ Yes □ No

                        a. If yes, has it been registered in Virginia?                                                                     □ Yes □ No

                    5. Are you, or any member of your immediate family, enlisted in the Virginia National Guard?                           □ Yes □ No

                    6. Are you, the spouse of, or the dependent of active-duty military personnel?                                         □ Yes □ No

                        a. Are you/they permanently stationed in Virginia? (If yes, include a copy of your/their orders.)                  □ Yes □ No

                        b. Does your/their Leave and Earnings Statement reflect Virginia as the state of residence?                        □ Yes □ No
                           (If yes, include a copy.)
                    7. If you are active duty military, did your spouse earn at least $10,300 in the last year, claim you as a             □ Yes □ No
                    federal tax dependent, and pay income tax to the state of Virginia?
                Answer this question, only if you worked in Virginia for the past 12 months but currently live outside of Virginia.
                   Did you file Virginia taxes on all income earned in Virginia for the last year?                          □ Yes □ No
sIGNAture




                 I certify that all information provided to the Graduate School and department on my                     return your completed form to:
                 application and during the entire admissions process is accurate. I understand that                                   Graduate School
                 upon my admission and enrollment I will be subject to the rules and regulations of the         Graduate Life Center at Donaldson Brown
                 university, including the Graduate Honor System (http://grads.ghs.vt.edu).                   Virginia Tech (0325) • Blacksburg, VA 24061
                                                                                                                                        Fax: 540/231-2039
                                                                                                                         Questions? Call 540/231-8636 or
                  APPlIcANt sIGNAture                                                             date               e-mail gradappl@vt.edu for assistance.
                GrAduAte IN-stAte tuItIoN request
                PAGe 1 of 1, AuGust 2008
THIS PAGE LEFT BLANK INTENTIONALLY.
                                                                                                 PAYMENT PROCESSING FORM

                 Application and diploma reorder fees may be paid via check or money order. Please complete the information below
                 and submit this document with the corresponding application or form to the Graduate School.



                 LAST/FAMILY NAME                                         FIRST/GIVEN NAME                     MIDDLE NAME             SUFFIX

                Student ID Number:                                       E-mail Address:
                                                        if known                                      @vt.edu account, preferred

                Daytime Phone:
                                              □ Home □ Office □ Mobile
REQUIRED INFO




                Please process payment for:

                   □ DEGREE-SEEKING APPLICATION FEE (I.E. MASTERS AND DOCTORAL STUDENTS) - $65

                   □ EXECUTIVE MASTERS OF BUSINESS ADMINISTRATION (EMBA) APPLICATION FEE - $90

                   □ APPLICATION FOR SIMULTANEOUS DEGREE - $65

                   □ NON-DEGREE-SEEKING APPLICATION FEE (I.E. COMMONWEALTH CAMPUS AND EXPEDITED NON-DEGREE PROGRAMS) - $25

                   □ APPLICATION FOR CERTIFICATE PROGRAM - $25

                   □ APPLICATION FOR READMISSION - $25

                   □ APPLICATION FOR VISITING STUDENT - $25

                   □ DIPLOMA REORDER - $20 PER DIPLOMA



                To Pay Via Check or Money Order

                Enclose your check or money order made payable to Treasurer, Virginia Tech.
                Checks and money orders must be drawn from a U.S. bank.




                                                                                                              Return your completed form to:
                                                                                                                             Graduate School
                                                                                                                          Graduate Life Center
                                                                                                                           at Donaldson Brown
                                                                                                                           Virginia Tech (0325)
                                                                                                                         Blacksburg, VA 24061
                                                                                                                            Fax: 540/231-2039
SIGNATURE




                 STUDENT SIGNATURE                                             date


                                                                                                         Questions? Call 540/231-8636 or
                                                                                                      e-mail gradappl@vt.edu for assistance.
                PAYMENT PROCESSING FORM
                PAGE 1 OF 1, SEPTEMBER 2009

				
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