Non-Candidate for Degree Application Instructions Rackham

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					                                    HORACE H. RACKHAM SCHOOL OF GRADUATE STUDIES
                                    University of Michigan
                                    S T U D E N T S E RV I C E S : A D M I S S I O N S
                                    915 E. Washington Street • 0120 Rackham Building • Ann Arbor, MI 48109-1070
                                    E-Mail: rackadmis@umich.edu • www.rackham.umich.edu/admissions


                          Non-Candidate for Degree Application Instructions

Rackham Unclassified Admission
Permission from the instructor of each course is required to register. If you have been denied admission, dismissed,
or placed on probation by a Rackham Program you cannot apply to take courses.

Purpose
Enrollment for 1 term only and limited to 2 courses total (1 course only per department or program).

Requirements
 • Undergraduate Grade Point Average (G.P.A.) minimum of 3.00.

 • A bachelor’s or master’s degree earned from a regionally accredited institution.

This type of admission is not applicable for international Students on F-1 visas. The current Department of
Homeland Security (DHS) requirement for F-1 visa holders is full-time enrollment, which is not applicable for this
status.



Departmental Non-Candidate for Degree (NCFD) Admission
Before applying, graduate department or program approval is required.

Purpose
Enrollment for 2 terms only in 2 or more courses in a single department or program.

Requirements
International students seeking Departmental Non-Candidate must be enrolled full-time (8 hrs per term for Fall and
Winter).



For Both Rackham Unclassified and Departmental Non-Candidate for Degree (NCFD) the
Following Applies

No courses may be taken in the Department of Psychology or the Ross School of Business under the Rackham
Unclassified status. These courses are restricted to degree seeking students only.

Application Materials Necessary for Consideration (Submitted Through The Application)
 • An Application Fee of $65 for United States Citizens and Permanent Resident Status and $75 for
   Non United States Citizens.
 •     The Statement of Purpose which must include the names and course numbers of the classes
       requested and purpose for requesting non degree enrollment.

 •     An official transcript with a bachelor’s or master’s degree posted.

 •     Resume or CV.

 •     The Admissions Code of Conduct.

Check with the graduate program regarding GRE scores and letters of recommendation requirements.

International Applicants
In addition to providing the materials stated above, submit:
  • Official ECPE, IELTS, MELAB, or TOEFL scores.

 • A copy of an I-20, DS-2019, passport, U.S. visa and I-94 card.

Credit Earned In Unclassified, NCFD Status
Courses elected by students in Unclassified NCFD status cannot be counted toward a Rackham degree program un-
less the student receives regular admission and the graduate chair of the degree program determines that the courses
are acceptable. Regular admission is not guaranteed. To be considered, a regular admission application must be
submitted.

Tuition and Fee Information
Unclassified NCFD students pay the same tuition as degree-seeking students. Financial Assistance is not provided
for Unclassified NCFD students. For tuition information visit the Registrar’s Office website at
http://www.umich.edu/~regoff/tuition/
	

Submit	completed	application	with	fee	and	all	supporting	material	to:
   Graduate Admissions
   915 E. Washington St.
   Ann Arbor, MI 48109-1070

For more information, please e-mail rackadmis@umich.edu.
Payment of Application Fee                                                                    HORACE	H.	RACKHAM	SCHOOL	OF	GRADUATE	STUDIES
                                                                                              UNIVERSITY	OF	MICHIGAN


  THE	FEE	FOR	UNITED	STATES	CITIZENS	AND	THOSE	WITH	PERMANENT	RESIDENT	VISA	STATUS	IS	$65.
  THE	FEE	FOR	NON-UNITED	STATES	CITIZENS	IS	$75.

  Your	signature	is	required	on	this	form	only	if	you	are	charging	the	fee	to	a	credit	card.	Write	clearly	and	double-check	your	credit	
  card	number	and	expiration	date	for	errors,	so	as	not	to	delay	the	processing	of	your	application.

  Applicant Name (required):

           I have enclosed a check for the $65 application fee made payable to the University of Michigan.

           I have enclosed a check for the $75 application fee made payable to the University of Michigan.

           I would like to charge the $65 application fee to my Visa or MasterCard: I would like to charge the $75 application fee to my
           Visa or Mastercard:

  	        Visa	Number																																																																					

  	        MasterCard	Number

  Cardholder	Name	(required):
  (Print your name as it appears on the card)

  Cardholder	Mailing	Address	(required):




  Cardholder	Phone	Number:	(											)

  Cardholder	E-mail	Address:	(if	available)

  Expiration	Date	(required):



  Signature	(required):

  Date	of	Signature	(required):


  Return	this	page	to	the	Horace	H.	Rackham	School	of	Graduate	Studies	with	your	application.
                                                                                                    HORACE H. RACKHAM SCHOOL OF GRADUATE STUDIES
Non-Degree Application Form - Page 1                                                                UNIVERSITY OF MICHIGAN
Acknowledgement                                                                                     Race/Ethnicity (For U.S. Citizens and Permanent Residents only)
I certify that all information in this application is true and complete, and                        The information requested below is optional and will not be used for admissions
that I am the author of my Academic Statement of Purpose and Personal                               purposes. It will be used to satisfy federal reporting requirements and may be used for
Statement. I understand that the University of Michigan may verify any                              other purposes allowed by law.
information I have provided. Falsification or omission of information and
credentials may result in the withdrawal of my application or in the revoca-                        Please indicate whether you consider yourself to be Hispanic or Latino.
tion of admission, financial award, or registration. I understand that all                               Yes, Hispanic or Latino: a person of Cuban, Mexican, Chicano, Puerto
credentials I submit become the property of the University of Michigan.                                   Rican, South or Central American, or other Spanish culture or origin,
                                                                                                          regardless of race.
Personal Information                                                                                     No, not Hispanic or Latino.
Full legal name as it appears on your passport
First (Given)                                                                                       In addition, select one or more of the following racial categories to describe
                                                                                                    yourself:
Last (Family)                                                                                            American Indian or Alaska Native: a person having origins in any of the
                                                                                                         original peoples of North and South America (including Central America),
Middle                                                                                                   and who maintains tribal affiliation or community attachment.
                                                                                                         Asian: a person having origins in any of the original peoples of the Far East,
Other name that appears on prior academic records or test score                                          Southeast Asia, or the Indian subcontinent including, for example, Cambo-
reports                                                                                                  dia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands,
Other First Name
                                                                                                         Thailand, and Vietnam.
                                                                                                         Black or African American: a person having origins in any black racial
Other Last Name
                                                                                                         groups of Africa.
Gender                                                                                                   Native Hawaiian or Other Pacific Islander: a person having origins in any
                                                                                                         of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Birthdate (month/day/year)                                                                               White: a person having origins in any of the original peoples of Europe, the
                                                                                                         Middle East, or North Africa.
Birthplace City
                                                                                                    U.S. Military Service
State/Province                                                                                      On active duty U.S. military

Country                                                                                             Veteran of U.S. armed forces

Native Language                                                                                     U.S. Reserves or National Guard

Previous Enrollment                                                                                 U.S. Military Dependent
If you have an 8 digit University of Michigan ID Number, Please
enter it here:                                                                                      Non-Degree Information
                                                                                                         Rackham Unclassified
Have you ever taken a class at the University of Michigan - Ann Arbor                                    Departmental Non-Candidate for Degree
Campus?                                                                                                  Name of Department

                                                                                                    Proposed Term/Year of Enrollment
Have you ever registered for a class offered by Rackham?
                                                                                                    CURRENT Address Information
                                                                                                    Address Line 1

If you have a Uniqname issued by the University of Michigan, please                                 Address Line 2
enter it here:                     @umich.edu
                                                                                                    City                                                  State/Province
United States Social Security Number
                                                                                                    Country
Social Security is optional, but important for helping us match the application materials you may
have on file. If you do not have a Social Security number, leave this space blank. Non-U.S.	Citi-   U.S. Zip/International Postal Code
zens, DO NOT enter national ID issued by your country.
                                                                                                    This address will be valid until             Valid indefinitely
Citizenship Status                                                                                                                               Current until
                                                                                                    E-mail
Country of Citizenship
                                                                                                    Home Phone                                 Work Phone                              Ext.
(Permanent Residents and Non-U.S. Citizens Only)
                                                                                                    Cell Phone
U.S. Permanent Resident Registration Number A

Visa Information (Non-U.S. Citizens only)                                                           PERMANENT Address Information
                                                                                                    F-1 and J-1 visa holders are required to provide a non-U.S. address.
U.S. Visa type you plan to obtain
                                                                                                    Your permanent address is the stable address of a relative or a friend which will be valid for an in-
                                                                                                    definite period of time into the future. This is the address where you may always be reached, even if
Will you have dependents accompanying you to Michigan?                                              your current mailing address changes.


If currently in the United States, Visa type:                                                       Address Line 1

                                                                                                    Address Line 2
SEVIS ID Number:



                                                                Rackham Non-Candidate for Degree Application 2012-2013
Non-Degree Application Form - Page 2                                                        HORACE H. RACKHAM SCHOOL OF GRADUATE STUDIES
                                                                                            UNIVERSITY OF MICHIGAN
City                                            State/Province                              Bachelor Degree Institution

Country
                                                                                            Dates Attended             /               to             /
U.S. Zip/International Postal Code
                                                                                            Location City                                   State/Province
Phone
                                                                                            Country

Michigan Residency                                                                          Major Field
The information provided in this section does not affect your potential for admission,      Major Field
but it will determine your tuition rate and should be read carefully.

It is the applicant’s responsibility to read the University’s Residency Classification      Degree/Diploma
Guidelines at http://ro.umich.edu/resreg.php and to apply for admission and register
under the proper residency classification.                                                  Level of Education

Are	you	now	a	Michigan	resident	as	defined	by	the	University’s	Residency	Classifica-        Degree Date          /            Degree Status
tion	Guidelines?	         Yes          No
                                                                                            GPA                               on a scale of
If	yes,	since	when?	(month/day/yyyy)

If you answered “Yes” and any of the following circumstances apply, you must file an        or Pass/Fail                      International Average
Application for Resident Classification and be approved to qualify for in-state tuition:
                                                                                            Institution 2
•      You currently live outside the state of Michigan for any purpose, including, but
       not limited to, education, volunteer activities, military service, travel, employ-
       ment.                                                                                Dates Attended            /               to               /
•      You have attended or graduated from a college outside the state of Michigan.         Location City                                   State/Province
•      You have been employed or domiciled outside the state of Michigan within the
       last 3 years.                                                                        Country

•      You are not a U.S. citizen or Permanent Resident Alien (if you’re a Permanent        Major Field
       Resident Alien, you must have a Permanent Resident Alien card).
                                                                                            Major Field
•      Your spouse, partner or parent is in Michigan as a nonresident student, medical
       resident, fellow or for military assignment or other temporary employment.           Degree/Diploma
•      You are 24 years of age or younger and a parent lives outside the state of Michi-
       gan.                                                                                 Level of Education

•      You are 24 years of age or younger and have attended or graduated from a high        Degree Date           /           Degree Status
       school outside the state of Michigan.
                                                                                            GPA                               on a scale of
•      You have attended or graduated from an out-of-state high school and have been
       involved in education pursuits for the majority of time since high school gradu-     or Pass/Fail                      International Average
       ation.

•      You previously attended any U-M campus (Ann Arbor, Dearborn, or Flint) as a          Institution 3
       nonresident.

Other circumstances may also require you to file a residency application.                   Dates Attended                /            to              /
For questions or assistance, contact the Residency Classification Office at (734) 764-      Location City                                   State/Province
1400.

The deadline dates for submitting an Application for Resident Classification apply to       Country
the term for which residency is sought and are as follows: September 30 for Fall Term,
January 31 for Winter Term, July 31 for Spring, Spring/Summer and Summer Terms.             Major Field
Applications must be received by 5 p.m. on the deadline date. Applicants who do not
file by the deadline date will be responsible for paying nonresident tuition. Processing    Major Field
times can be lengthy. It is recommended that applications be submitted as soon as
possible.                                                                                   Degree/Diploma
Education Information                                                                       Level of Education
If you attended a College “affiliated to” a University, please list the name of the Uni-    Degree Date           /           Degree Status
versity, not the affiliated College.
                                                                                            GPA                               on a scale of
1.     List first, the institution where you have earned or will earn a Bachelor’s.
                                                                                            or Pass/Fail                      International Average
2.     List second, the institution where you have earned or will earn a degree (Ex: 2nd
       Bachelor’s, Master’s, Professional or Doctoral degree) in chronological order by     Institution 4
       dates of attendance, beginning with institution 2.

3.     Do not send a transcript, from an institution where you did not earn or will not     Dates Attended                /            to              /
       earn a degree, to Rackham (Ex: Community or Junior College, or non-degree
                                                                                            Location City                                   State/Province
       study or study abroad coursework) unless your intended graduate program re-
       quires this information.
                                                                                            Country
4.     Do not include high school attended.                                                 Major Field

                                                            Rackham Non-Candidate for Degree Application 2012-2013
Non-Degree Application Form - Page 3                                                         HORACE H. RACKHAM SCHOOL OF GRADUATE STUDIES
                                                                                             UNIVERSITY OF MICHIGAN

Major Field

Degree/Diploma

Level of Education

Degree Date              /           Degree Status

GPA                                  on a scale of

or Pass/Fail                         International Average

Institution 5


Dates Attended                   /                to             /

Location City                                          State/Province

Country

Major Field

Major Field

Degree/Diploma

Level of Education

Degree Date                  /       Degree Status

GPA                                  on a scale of

or Pass/Fail                         International Average

Test Score Information

ECPE                                    IELTS

MELAB

Internet-based TOEFL                     Paper-based TOEFL

Date Taken                              Total /Final score

GRE Date Taken or Expected Date

GRE Test Scores and Percentiles (if available)

Verbal                   /               %

Quantitative         /                  %

Analytical           /                  %

GRE Subject Test Score and Percentile

Subject Test Name

Score / Percentile                            /                      %

Subject Test Name

Score / Percentile                            /                      %


GMAT Date Taken or Expected Date

GMAT Score Total

MCAT Date Taken or Expected Date

MCAT Score Total




                                                                Rackham Non-Candidate for Degree Application 2012-2013
Admissions Conduct Code - Page 4

 Please answer the following questions, sign this form and return it to the          For	office	use	only
 Rackham Graduate School with the Rackham portion of your applica-                   CC:
 tion.
                                                                                     Emplid#

 Last Name (Family)
                                                                                     Explanation:
 First

 Middle

 Term Applying for

 Current	Mailing	Address

 Street, Apt. No.

 City

 State

 Country

 Postal Code

 Valid	from (month/year)                    to (month/year)

   1. Have you ever been expelled, suspended, or placed on probation
      by any secondary school or college you have attended for reason of
      academic dishonesty or because of an offense that harmed or had the
      potential to harm others?
           No		       Yes

   2. Have you ever been convicted of a criminal offense other than a
      minor traffic violation, or been found to be delinquent by a juvenile
      court, or are there such charges currently pending against you at this
      time?
           No		        Yes

 If	you	answer	yes	to	either	of	these	questions,	you	must	submit	a	full	
 explanation.

 By my signature, I certify that all answers I have given on this application
 and the essay responses are complete and accurate to the best of my
 knowledge. I understand that falsification or omission of information or
 credentials may result in revocation of admission.



 Signature
 (required):

 Date

 Mail	to:		   Attention:	Rackham	Unclassified	NCFD	Application
 	 	          Rackham	Graduate	School
 	 	          University	of	Michigan
 	 	          915	E.	Washington	St.
 	 	          Ann	Arbor,	MI	48109-1070
 	 	          Phone:	(734)	764-8129
 	 	          Website:	www.rackham.umich.edu


                                                                                     If you need more space please attach a separate page.




                                                     Rackham Non-Candidate for Degree Application 2012-2013
                                                                               HORACE	H.	RACKHAM	SCHOOL	OF	GRADUATE	STUDIES
Statement of Purpose - Page 5                                                  UNIVERSITY	OF	MICHIGAN

Briefly explain your purpose for electing classes as a non-degree student. Include the name and course number of the class you wish to take. No classes in
Psychology or Business Administration are permitted.




 Signature:                                                                                              Date:




                                                    Rackham Non-Candidate for Degree Application 2012-2013
                                                                                HORACE	H.	RACKHAM	SCHOOL	OF	GRADUATE	STUDIES
Curriculum Vitae/Resume - Page 6                                                UNIVERSITY	OF	MICHIGAN

Please provide a curriculum vitae or resume that describes your education, work experience, research and teaching experience, professional affiliations,
volunteer activity and community engagement, honors and awards. (4 page limit)




                                                     Rackham Non-Candidate for Degree Application 2012-2013

				
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