NICHOLS COLLEGE
c/o Palm Beach Community College MS#48 4200 Congress Avenue Lake Worth, FL 33461 561-868-4001 Fax: 561-623-6448 Marla.Friedman@nichols.edu www.nichols.edu/pb
APPLICATION FOR GRADUATE ADMISSION
A. PERSONAL INFORMATION
NAME ___________________________________________________________________________ Last First Middle Maiden SOCIAL SECURITY NUMBER ________ - ________ - ________ DATE OF BIRTH ______ / ______ / ____ PERMANENT ADDRESS ________________________________________________________________________ Number and Street P.O. Box City State Zip Code HOME PHONE __________________________ CELL PHONE _______________________________ WORK PHONE ______________________________ FAX NUMBER __________________________ EMAIL ____________________________________________________________________________
B. BACKGROUND INFORMATION
GENDER:
□ Male □ Female □ Yes □ No
CITIZENSHIP: Are you a citizen of the United States?
If no, Visa Status: ___________________________ Country of Citizenship: _____________________
C. ADMISSIONS INFORMATION
Financial Aid: Do you wish to apply for financial aid?
□ Yes □ No
A Free Application for Federal Student Aid (FAFSA) is required for financial aid review. Apply online at www.fafsa.ed.gov. The FAFSA code for Nichols College is: 002197.
GRADUATE PROGRAM CHOICES:
□ Master of Business Administration (MBA) □ Master of Business Administration (Concentration in Sport Management) □ Master of Business Administration (Concentration in Security Management) □ Master of Organizational Leadership (MOL) □ Certificate of Advanced Leadership Studies
How did you hear about Nichols College?
□ Admissions Counselor □ Advertisement □ College Fair
□ Friend □ HR Director □ Relative □ Other _______________________________
Please list other colleges / universities you are applying: ___________________________________________________________________________________
D. EDUCATIONAL BACKGROUND
COLLEGE / UNIVERSITIES ATTENDED __________________________________________________________________________________
Name Location (City, State) Dates of Attendance CEEB Code # _____________________________________________________________________________________________________ Name Location (City, State) Dates of Attendance CEEB Code # ______________________________________________________________________________________________________ Name Location (City, State) Dates of Attendance CEEB Code #
E. EMPLOYMENT INFORMATION
CURRENT EMPLOYER: _________________________________________________________________________ ADDRESS: ____________________________________________________________________________________
Number & Street City State zip
F. CERTIFICATE OF APPLICATION
I hereby apply for admission to Nichols College. If admitted, I agree to abide by its regulations. I certify that the foregoing information is true and complete to the best of my knowledge and fully realize that omission or falsification of information will be considered sufficient reason for rejection of this application or for dismissal. APPLICANT’S SIGNATURE: ________________________________________ DATE: ______________
Nichols College offers admission without regard to color, race, creed, national origin, age, religion, gender, sexual orientation, veterans status or disability, and follows the guidelines for records established by the Family Educational Rights and Privacy Act (1974).
G. APPLICATION CHECK LIST
□ Completed Application □ $25 Application Fee (waived for Palm Beach Campus) □ Resume □ Personal Statement
(Please attach to this form a separate typewritten statement in which you will discuss your career plans and objectives and how the MBA degree fits into your goals).
□ Two Letters of Recommendation
(At least two letters of recommendation from professors, supervisors, and/or colleagues are required for MBA admission).
□ College / University / Military Transcripts
(All official transcripts from accredited institutions that you have attended, whether or not you are seeking transfer of credits)
□ TOEFL Scores (International Students Only)
(If your native language is not English, you must provide your TOEFL Scores before registration).