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6 2012If applicable, please indicate when the Test of English as a Foreign Language (TOEFL) was or will be taken: /TOEFL Date (MM/DD/YYYY)Are you a citizen of the United States? YesNoAre you a permanent resident of the United States?YesNoIf you are not a U.S. citizen or permanent resident, please complete the following: If accepted for admission to Pace University, will you need a Certificate of Eligibility (I-20) for a student visa? If no, please indicate visa status you hold or will hold: If yes, please provide the information below: YesNoVisaOccupation in your home countryCity of birth Country of birth Country of citizenship Are you or an immediate family member an employee of Pace University?YesNoIf yes, please explain:Current employerAre you now in the USA?YesNoIf yes, please indicate your present visa status below and provide your home country address:Visa statusCity StateCollege / Organization / EmployerHome Country Address:Please explain here if this visa status expires prior to your anticipated Pace University enrollment date:(Please note: If you do not provide this information we cannot process your I-20)Will dependents accompany you in the U.S.?YesNoIf yes, please provide information below: ­(Please attach information regarding additional dependents who will accompany you.)Last NameFirst NameMiddle Name//Date of Birth (MM/DD/YYYY)City of birth Country of birth Relationship to studentP­­­­­­­­­­­­­­­­lease provide the information below:Does your employer provide tuition reimbursement?YesNoCityStateCountryWhich of the following was the biggest influence in your decision to apply to Pace University? (Check the appropriate box):Accelerated Admission Day Event Attended a Pace Information SessionCampus LocationCareer Services and Internship ProgramCollege or Professional FairCourse OfferingsFinancial Aid/Scholarship OfferingsInformation on Pace websiteOnline Chat with Department/AdmissionsPhone or in-person meeting with Pace Admission CounselorSchool Publication received in the mailRecommendation from current Pace StudentRecommendation from Pace AlumniRecommendation from Pace Faculty/Staff MemberRecommendation from EmployerTour of Pace University campusAttended a Special Event with a chosen program

A personal statement, resume, and recommendation are required. Please refer to page 4 of this booklet. 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, practices, and procedures of Pace University, whether published or unpublished, and I agree to comply with them.Applicant's SignatureDate (MM/DD/YYYY)Please print name2012 7APP REC DATE (MM/DD/YYYY)FEE REC DATE (MM/DD/YYYY)////FOR OFFICE USE ONLYInstitution AttendedCity State//Start Date (MM/YY)End Date (MM/YY)Degree Received:AssociateMaster'sBachelor'sNonePlease list in chronological order all colleges or universities attended since your high school graduation. Be sure to include all institutions at which you were, are, or will be enrolled prior to your anticipated Pace University graduate program entry term, not only those institutions from which you received a degree. An official transcript from each institution must be received by the Pace University Office of Graduate Admission to which you are sending this application. All documents not issued in English must be supplemented by professionally certified English translations (See International Student Information).Country/Date or Expected Date of Degree (MM/YY)Institution AttendedCity State//Start Date (MM/YY)End Date (MM/YY)Degree Received:AssociateMaster'sBachelor'sNoneCountry/Date or Expected Date of Degree (MM/YY)Institution AttendedCity State//Start Date (MM/YY)End Date (MM/YY)Degree Received:AssociateMaster'sBachelor'sNoneCountry/Date or Expected Date of Degree (MM/YY)Institution AttendedCity State//Start Date (MM/YY)End Date (MM/YY)Degree Received:AssociateMaster'sBachelor'sNoneCountry/Date or Expected Date of Degree (MM/YY)Institution AttendedCity State//Start Date (MM/YY)End Date (MM/YY)Degree Received:AssociateMaster'sBachelor'sNoneCountry/Date or Expected Date of Degree (MM/YY)Non-Discrimination StatementPace University prohibits and will not tolerate discrimination or harassment in any of its programs or activities on the basis of sex, race, color, national origin, religion, creed, age, dis­ability, citizenship, marital status, sexual orientation, genetic predisposition or carrier status, veteran status, or any other characteristic protected by law. Pace University's Affirmative Action Officer has been designated to handle inquiries regarding the University's non-discrimination and harassment policy and may be contacted at 156 William Street, New York, New York 10038, (212) 346-1310, or at Costello House, 861 Bedford Road, Pleasantville, New York 10570 (914) 773-3856.Reasonable Accommodations Pace University prohibits discrimination on the basis of disability and is committed to ensuring equal access to the application process for applicants with disabilities. An applicant who may require a reasonable accommodation in order to complete the application process should contact the Director of Disability Services on either the New York City (212) 346-1526 or Pleasantville campus (914) 773-3710.Have you ever been placed on academic or disciplinary probation or been dismissed from any institution?If yes, please attach your statement of the circumstances. YesNoHave you ever been convicted of or plead guilty to a misdemeanor or felony? If yes, please explain on a separate piece of paper (response required).Note: Answering yes to either of the two questions above does not automatically bar you from admission to Pace UniversityYesNo