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Work toward greatness.2012 17APPLICATION FOR GRADUATE NON-DEGREE STATUSTo apply and register as a Non-Degree student, you must:Contact the academic department listed below in order to schedule an advisement session and to obtain approval. (You will need to provide a copy of your undergraduate and/or graduate transcripts.)Dyson College of Arts and SciencesCounseling (914) 773-3309 Environmental Science (914) 773-3655Forensic Science (212) 346-1967Media and Communication Arts (914) 773-3790Public Administration (914) 422-4299Publishing (212) 346-1431Psychology (212) 346-1506Submit the department-approved application and registration form with a non-refundable $70 check or money order to the appropriate Office of Graduate Admission.Office of Graduate Admission Office of Graduate AdmissionPace University Pace UniversityOne Pace Plaza One Martine AvenueNew York, NY 10038-1598 USA White Plains, NY 10606-1932 USAPhone: (212) 346-1531 Phone: (914) 422-4283Fax: (212) 346-1585 Fax: (914) 422-4287E-mail: gradnyc@pace.edu E-mail: gradwp@pace.edu   1. Name___________________________________________________________________________________________________________ Last First Middle   2. Female   Male (Optional)   3. Current Mailing Address ___________________________________________________________________________________________   4. Day Telephone (________) _____________________________ 5. Evening Telephone (________)_______________________________   Area Code / Number Area Code / Number   6. Fax (________)__________________________ 7. E-mail ________________________________ Area Code / Number   8. Please indicate the entry term for which you are applying: Fall _______ Spring _______ Summer I _______ Summer II _______ Year Year Year Year   9. At which campus location do you plan to attend classes?  New York City    Westchester   10. Have you previously applied to any graduate program of Pace University? Yes No If yes, please explain:_______________________________________________________________________________________________________________________COLLEGE OF HEALTH PROFESSIONSUndergraduate/Graduate Institution AttendedLocationDates AttendedMajorDegree AwardedDate or Expected Date of Degree  11. Please list in chronological order all institutions attended since your high school graduation.If I enroll in the Seidenberg School of Computer Science and Information Systems as a non-degree student, I confirm that I have the appropriate undergraduate course work or its equivalent for the courses in which I register. If I enroll in the College of Health Professions, Dyson College of Arts and Sciences, or School of Education, I confirm that I hold a U.S. bachelor's degree or its equivalent. My signature below further confirms that I do not require a student visa or exchange visitor's visa to attend graduate classes at Pace University. I understand that I may enroll for a maximum of 12 credits as a non-degree student and that I am not guaranteed acceptance to a graduate program of Pace University. I further understand that if I am accepted to a degree program, generally, credit for only two courses successfully completed as a non-degree student may be applied to a program.I certify that all of the information provided by me or on my behalf in support of my application for admission is complete and accurate. I acknowledge that I am obligated to supplement my application as soon as I know or reasonably should know if the information I have provided or that was provided on my behalf is inaccurate or incomplete. I also certify that the personal statement submitted in support of my application for admission is solely my own original work. I acknowledge that Pace University may, at its sole discretion, verify any information submitted in conjunction with my application. I acknowledge that if I omit relevant information or provide inaccurate information or information that is misleading, submit a personal statement that is not solely my own original work, or of I fail to supplement my application as required, Pace University may, at its sole discretion, deny my application for admission, rescind my admission, impose disciplinary sanctions against me, dismiss me from Pace University, and/or rescind any degrees or certificates awarded to me by Pace University.I acknowledge that the application fee I have paid or will pay in the future is not refundable. I acknowledge that I am bound by the policies, rules, and regulations of Pace University, whether published or unpublished, and I agree to comply with them.Signature ____________________________________________________________ Date ___________/__________/__________ Month Day YearFOR OFFICE USE ONLY FEE REC DATE _____/_____/_____ BY ________________ DATA ENTRY DATE _____/_____/_____ BY _____________ College of Health Professions (212) 346-1439 (914) 773-3331Seidenberg School of Computer Science and Information Systems (212) 346-1005 (914) 422-4191School of Education (212) 346-1338 (914) 773-3829