APPLICATION FOR GRADUATE ADMISSION QXD M FACULTY OF GRADUATE

APPLICATION FOR GRADUATE ADMISSION S6016839.QXD-M FACULTY OF GRADUATE STUDIES UNIVERSITY OF MANITOBA, 500 UNIVERSITY CENTRE WINNIPEG, MANITOBA, CANADA R3T 2N2 PHONE: (204) 474-9377 FAX: (204) 474-7553 WORLD WIDE WEB: http:/www.umanitoba.ca/graduate_studies EMAIL: graduate_studies@umanitoba.ca INSTRUCTIONS TO THE APPLICANT: Complete Part A of this form. Applicants are required to submit the application and documentation to the department to which they are applying. Please ensure that all applicable required documentation as indicated is included or that arrangements have been made to forward those documents not included with the completed Application for Graduate Admission form directly to the department. PLEASE NOTE: The Faculty of Graduate Studies will NOT consider your application until all of the required documents are received. Incomplete applications will be destroyed after six(6) months. Application Requirements Completed Application for Graduate Admission Form Application Fee: Canadian/Perm. Residents $75.00* (CDN); International Applicants $90.00* (CDN) (subject to change) Applications will NOT be processed unless accompanied by the correct fee in Canadian or equivalent U.S. funds. The application fee is NON-REFUNDABLE and NOT CREDITED AGAINST TUITION. The fee may be paid by international money order, bank draft, or cheque in Canadian funds made payable to “THE UNIVERSITY OF MANITOBA”. DO NOT SEND CASH. WE DO NOT ACCEPT PAYMENT BY CREDIT CARD. Complete academic record and all official transcripts. ** Copy of birth certificate, or passport (only those students who have never registered at this University before). Copy of marriage certificate or of other official evidence indicating name change (applicable only to those applicants whose name on the application form differs from that on the academic record, birth certificate, or other documentation). Two letters of recommendation must be sent to the department to which the student is applying. Letters must arrive in individual sealed envelopes with the referee’s signature across the flap of the envelope. Applicants should check with the department to which they are applying as some departments may require more than two letters on a departmentally approved form. English Language Proficiency Test (see reverse/next page for details) * Important Notes Regarding Application Fee Payments: APPLICATION PROCEDURES Read page 1 of the application for information on general requirements and procedures. Keep this sheet for your reference. Complete the application form in full, typing or clearly printing all information; if additional space is required, use a separate sheet of paper and attach to application form. Read the Declaration Statement at the end of PART A of the Application and sign the form. In addition to the completed application form, please ensure that all documentation listed on this page is sent directly to the department to which you are applying. Contact the department directly to check deadline dates for application and if any further documentation is required (e.g., Graduate Records Examination, research proposal, sample of academic writing, etc.). For Visiting Graduate Students: In addition to the completed application form, the following documentation is required. A letter from the Faculty of Graduate Studies of your home institution confirming that you are currently a graduate student and stating the specific courses that you have been granted permission to take at the University of Manitoba. a) The money order, bank draft or cheque should be MICR encoded with the cheque number, transit number (usually 8 digits) and account number. MICR encoding is the preprinted numbers on the bottom left hand side of the money order, bank draft or cheque draft. E.g. of MICR encoding ψ 12345 123 123 123 1 b) If the fee is not MICR encoded, the transit number, the account number and the complete bank address must be provided on the payment by the bank. c) If the application fee is not acceptable, it will be returned to the applicant. ** Important Notes Regarding Official Transcripts: 1) Transcripts must be received by the department in envelopes that have been sealed and endorsed (stamped and signed) by the issuing institution to be considered official. In cases where the transcript does/will not clearly state that a degree has been conferred, an official degree certificate (original or certified copy) is required to accompany the transcript. 2) Where academic records from a country other than Canada are produced in a language other than English, the applicant must arrange for the submission of official literal translations of all records. To be official, original language documents and the English translations must arrive together in an envelope that has been sealed and endorsed (stamped and signed) by the issuing institution. 3) All documents must arrive from the general records office (e.g., the Registrar, Controller, Archives, etc.) of the issuing institution to be considered official. 4) All documents submitted in support of an application become the property of the University of Manitoba and will not be returned to the applicant. 5) Name changes/differences on documents must also be substantiated by appropriate documentation. DEADLINES FOR APPLICANTS Applicants are advised to confirm the deadline of the department to which the application is being made. Contact information for each department can be found at http:/www.umanitoba.ca/graduate_studies/prospective. International Applicants (excluding citizens/residents of the US) requiring Study Permits to enter Canada should submit their applications (and required documents) at least 9 (nine) months before the desired date of admission (or sooner if the departmental deadline so requires) to allow enough time for processing of the required visa. It is the applicant’s responsibility to ensure that the department receives all the documents (official transcripts, translations, test scores, letters of recommendation, etc.) required for admission in advance of the Departmental deadline. Continued on Reverse / Next Page PART I English Language Proficiency Tests A successfully completed English Language Proficiency Test is required of all applicants unless they have received a high school diploma or university degree from Canada or one of the countries listed on the English Language Proficiency Test Exemption List). If applicable, this score is required as a basis for admission and applicants will NOT be accepted subject to receipt of an acceptable score. Documented proof of either the above must be submitted with the application for admission. Please note: scores more than two years old are not acceptable. English Language Proficiency Test Scores accepted by the Faculty of Graduate Studies are as follows: Test of English as a Foreign Language (TOEFL) - minimum score 550 paper based, 213 computer based, University of Manitoba institution code 0973. Note: minimum TOEFL scores will be changing as of Summer / Fall 2004. Please refer to the Faculty of Graduate Studies website for further updates. University of Michigan English Language Assessment Battery (MELAB) - minimum score 80%; International English Language Testing System (IELTS) - Academic Version - minimum overall band of 6.5; Canadian Test of English for Scholars and Trainees (CanTEST) - minimum score of 4.5 in listening and reading, 4.0 in writing; Academic English Program for University and College Entrance (AEPUCE) - minimum of 65%. Canadian Academic English Language Assessment (CAEL) - minimum 60 overall and 60 on each subject. English Language Proficiency Test Exemption List* Applicants holding secondary school diplomas and/or university degrees from the following countries are exempt from the English Language Proficiency Test requirement: Australia Belize British West Indies Canada Guyana Ireland Kenya Lesotho New Zealand Nigeria Puerto Rico Singapore South Africa United Kingdom U.S.A. Zambia Zimbabwe * An updated list of additional countries exempt from the English Proficiency Test can be found at http://www.umanitoba.ca/graduate_studies/prospective/admissions/english.shtml PART II Canadian Aboriginal Peoples This information is collected to assess the University’s progress towards meeting its commitment to increase the recruitment and retention of Aboriginal students. Your response to these questions is voluntary and strictly confidential. It will be used only for statistical purposes. A Canadian Aboriginal Person is a North American Indian or a member of a First Nation, a Métis or an Inuit. North American or First Nation includes “Status,” “Treaty,” or “Registered” Indians, as well as “Non-Status,” and “Non-Registered” Indians. The University of Manitoba is committed to the principle of merit and to the equitable participation and success of underrepresented groups such as women, Aboriginal peoples, members of visible minority groups, persons with disabilities and persons who traditionally have not had the opportunity for university studies because of economic, social, cultural reasons, lack of formal education or residence in remote areas. FOR INFORMATION ON GRADUATE AWARDS AND POTENTIAL FUNDING PLEASE VISIT OUR WEBSITE AT http://www.umanitoba.ca/graduate_studies/awards_scholarships/index.shtml AND CONTACT THE DEPARTMENT TO WHICH YOU ARE APPLYING. For Office Use Only S6016839.QXD-M Application for GRADUATE ADMISSION FACULTY OF GRADUATE STUDIES STUDIES University of Manitoba 500 University Centre Winnipeg, Manitoba CANADA R3T 2N2 PART A: To be completed by applicant (see Pages 1 and 2 for instructions). 1. Previous Application to the University of Manitoba Have you previously registered or applied to take courses at the University of Manitoba: If yes, University of Manitoba Student or Reference Number Are you currently enrolled at the University of Manitoba: Yes No Yes No 2. Personal Information (please print or type) Family Name (Surname) First (Given) Name and Middle Name(s) Former Name (if applicable) TITLE (please circle) Mr. Miss. Mrs. Ms. 0 1 2 8 Male Dr. 3 Single 0 Married 2 1 Female Single Married 3 Birth Date (YR / MO / Day) Canadian Social Insurance Number Province or Country of Birth Country of Citizenship Current Mailing Address Number and Street City and Province Country E-mail (please print) Postal Code Home Phone Number Office Phone Number Permanent Address (if different from Current) Number and Street City and Province Country Permanent Resident (Circle) Perm. Res. 3 Minister’s Permit 6 International Students (Circle) English 1 French 2 Study Permit (non-sponsored) 7 Other (specify) 3 Postal Code Study Permit (sponsored) 8 Employment Visa 2 Year Visitor’s Visa 4 Month Home Phone Number State Proposed or Actual Date of Entry into Canada If sponsored as an International Student, give name of Sponsoring Agency or Government Year Month Primary Language (circle) Refers to Mother Tongue Date on which you wrote or plan to write TOEFL CANADIAN ABORIGINAL PEOPLES (please see instructions on back of cover page) (Part II) Are you a Canadian Aboriginal person? Yes No If YES, are you.. First Nations Métis Inuit Please send info on Aboriginal Programs and Student Services How did you find out about the University Of Manitoba? (Please check the appropriate box) Recruitment Fair Publications Internet Friend / Family Faculty Other Continued on Reverse / Next Page 3. Program Details Degree Sought (M.A., M.Sc., Ph.D., Occasional, etc.) Major Department Field of Special Interest Name of Preferred Supervisor Proposed START DATE MAY (Year) JULY (Year) If you are employed academically With this University, give position SEPTEMBER (Year) JANUARY (Year) Expected Status Full-time Part-time 4. Academic History and Supporting Documentation A complete listing of all post-secondary institutions you have attended or are attending is required. Please attach additional sheet if required. Name of Institution Location From Yr. / Mo. To Yr. / Mo. Program in Which You Were Enrolled (e.g. B.A., B.Sc., etc.) Major Subject Degree Conferred Yes/Date No Please attach list of academic awards, publications and / or any research or other relevant experience. List Referees Whom You Have Requested to Send Letters of Recommendation: NAME: POSITION ADDRESS NAME: POSITION ADDRESS 5. Declaration This personal information is being collected under the authority of The University of Manitoba Act and will be used for the purposes of admission, registration, decisions on your academic status and to provide you with information related to your studies at the University. It may be shared with other educational institutions. Information regarding graduation and awards may be made public. Upon your graduation, name, address and degree information you have provided will be given to and maintained by the Alumni Records department in order to assist in the University’s advancement and development efforts. This information is protected by the Protection of Privacy provisions of Manitoba’s Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, contact the FIPPA Coordinator’s Office, (204) 474-8339, c/o Archives and Special Collections, 331 Dafoe Library, University of Manitoba, Winnipeg, MB R3T 2N2. I HEREBY CERTIFY THAT I HAVE READ AND UNDERSTOOD THE INSTRUCTIONS AND INFORMATION SHEET ATTACHED TO THIS APPLICATION FORM AND THAT ALL STATEMENTS MADE IN CONNECTION WITH THIS APPLICATION ARE TRUE AND COMPLETE. I AUTHORIZE THE UNIVERSITY, INDIVIDUAL COMPANY OR OTHER LEGAL ENTITY TO VERIFY ANY INFORMATION, TRANSCRIPTS, OR REFERENCE LETTERS PROVIDED AS PART OF THIS APPLICATION. I ACCEPT THAT ANY INFORMATION ON FALSIFIED DOCUMENTS MAY BE SHARED WITH THE ASSOCIATION OF REGISTRARS OF THE UNIVERSITIES AND COLLEGES OF CANADA. I UNDERSTAND THAT MY APPLICATION WILL BE REJECTED IF I HAVE NOT DISCLOSED MY COMPLETE ACADEMIC RECORD OR HAVE SUBMITTED FALSE INFORMATION IN SUPPORT OF MY APPLICATION TO THE FACULTY OF GRADUATE STUDIES. IN SUCH AN EVENT I UNDERSTAND THAT FUTURE APPLICATIONS FROM ME WILL NOT BE CONSIDERED. Date: Signature: PART B: For Office Use Only To be completed by the department and returned with official transcripts to the Faculty of Graduate Studies. For applicants being recommended for the Ph.D. Program, this application must be returned with transcripts and the Ph. D. Selection Committee Report. CATEGORY Ph.D. Masters Occasional Diploma Pre-Masters Visiting Name of Advisor The Department of Recommends: Acceptance Rejection SPECIAL CONDITIONS in current year’s studies. (A) Minimum standing of (B) Successful completion of degree and presentation of official transcript (C) Other Home University HEAD OF MAJOR DEPARTMENT (Signature) DEAN OF GRADUATE STUDIES Date: PART C: FOR OFFICE USE ONLY Batch # Date: App. Fee.