Non-Matriculated Application

Please complete and return to the Center for Graduate Studies to the address or fax number at the end of the application. In addition to this application, proof of completion of bachelor's degree is required. You may submit an unofficial transcript for admission purposes, however official transcripts must be submitted no later than the end of the first month of class, or your enrollment status may be interrupted.

Please check the Semester and year for which you are applying:
Winterim Spring Summer Fall


Please fill in the information regarding the course(s) you wish to be approved to register for:

CRN
(i.e. 20368)
Subject
(i.e. GRED)
Course #
(i.e. 600)
Course Name
(if available)
Section
No.
Credit
Hours
Have you ever attended SUNY Potsdam? Yes      No
If yes, when?
Student Identification number

Personal Information

Last Name:
First Name:
Middle Initial:
Former Name:
Date of Birth: (mm/dd/yy)
Gender:

Address:
City:
State/Province :
Zip:
E-mail address:
Home Phone:
Alternate Phone and type:

College Information

Please list all Undergraduate schools and colleges attended, beginning with the most recent, and include date(s) of attendance. Please contact the Center for Graduate Studies if you need to submit additional information on institutions attended.

College / University Start Date End Date Major Degree

Ethnicity - This section is optional

Are you Hispanic/Latino?:    Yes    No   

If you are Hispanic/Latino, what is your background?


All Applicants, please indicate your race - select one or more




Other Biographical Information

Are you a U.S. Citizen: Yes
No
Dual Citizenship: Yes
No
State of Legal Residence
Are you a Veteran or a dependent of a Veteran Yes
No

Declarations

I declare that I have not been "dismissed;" and I am eligible to return to or graduate from the college(s) and/or high school(s) listed on my SUNY Potsdam Non-Matriculated Graduate Student Application.

Check here if you have ever been
      Convicted of a felony?
      Dismissed from a college for disciplinary reasons?

I understand that an official transcript from my undergraduate school(s) must be received by the Center for Graduate Studies that my grade point average (GPA) must be within acceptable limits, and that my bachelor's degree must be awarded before I can register for any course.

In affirming its commitment to equality of opportunity for all individuals, SUNY Potsdam has an affirmative action program, which actively seeks faculty, staff, and students without regard to race, color, religion, sex, age, marital status, national origin or physical handicap.