Applying for Graduate AdmissionThe University of Iowa Graduate College • Iowa City, Iowa

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The University of Iowa has been a leading center of graduate educa-tion since the turn of the 20th century. Advanced degrees in nearly 100 areas are offered to the graduate student population, which makes up approximately one-fifth of the university’s total enrollment.

We are proud of the excellence of our academic programs and believe that our students find the university and the Iowa City community a satisfying and rewarding place to further their education.

The Admission ProcessThis application is designed for prospective graduate students who plan to pursue a graduate program. (To apply online, go to grad.admissions.uiowa.edu/apply.)

Refer to page 3 for information about where to send application materials. Application materials must be sent to two different university offices: the Office of Admissions and your academic department.

Application InstructionsPlease print legibly in ink. Most items on this application are self-explanatory. Instructions for the others follow.

A. Personal InformationA1. Name—List your name as you would like it to appear on all university records. (International students: list your name as it appears in your passport.) If your name changes before your enrollment, please notify the Office of Admissions in writing.

A4–5. Citizenship—If you are a permanent resident of the United States, submit a copy of your Permanent Resident (green) Card. If you mark “other,” you must provide your immigration status (e.g., refugee, asylee, applicant for Permanent Resident Card) and country of citizenship.

International applicants must indicate their country of citizenship and the nonimmigrant visa type they intend to hold while enrolled at the university.

A6. Social Security Number (SSN)—We will use your social security number to verify your identity for record-keeping purposes and to help match transcripts and other materials with your admis-sion application. It will not be used as your University ID number. Students who choose not to provide their social security number will be ineligible for financial aid through the University of Iowa Office of Student Financial Aid. Your social security number will be safeguarded by the university and will not be displayed on official records or made available to others. If you do not have a social security number, leave this item blank.

A12. Ethnic/Racial/Tribal Affiliation Information—Your response to this item is voluntary (international students may proceed to the next item). To comply with the U.S. Department of Education regulations concerned with Title VI of the Civil Rights Act, the University of Iowa must report statistical summaries of the student body. This information is confidential and does not appear on academic records. Information regarding individual students is not disclosed outside the university without the student’s written consent.• Hispanic/Latino(a): a person of Mexican, Puerto Rican, Cuban, Central

or South American, or other Spanish culture or origin, regardless of race.• Alaskan Native or American Indian: a person having origins in any of

the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

• African American/Black: a person having origins in any of the black racial groups of Africa.

• Native Hawaiian or Other Pacific Islander: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

• Asian: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

• White: a person having origins in any of the original peoples of Europe, North Africa, or the Middle East.

A14–15. Current Mailing Addresses—Complete these three lines as you would address an envelope to be mailed to yourself.

From Aug. 15 through May 15, we will correspond with you at your current address. From May 16 through Aug. 14, your home address will be used. If either address changes, please notify the Office of Admissions. International students will receive correspondence at their current address at all times.

B. Admission InformationB1. Session—Indicate the month and year of the first session in which you intend to enroll. Your admission is valid only for the session designated in your admission letter. If you are unable to register for that session, but wish to enroll at a later time, departmental approval must be initiated by requesting a change of session from the Office of Admissions.

B2–4. Department and Degree Objective—Please choose one program/department and an appropriate degree objective from the list of graduate programs on pages 4–6. List the department and indicate the appropriate department code. (When writing to an academic department, be sure to use the program name and campus address as it appears on this list.)

Students cannot be considered for admission to two or more programs/departments at the same time unless they are applying for an approved joint program (see list at grad.admissions.uiowa.edu/academics).

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C. Educational InformationC1. Postsecondary Education—Two official copies of academic records/transcripts from each institution attended are required. Have one set sent directly to the Office of Admissions and have the second set sent directly to your academic department. U.S. and Canadian transcripts must arrive in a sealed envelope mailed directly from the institution. Academic records from other countries must bear the true stamp or seal of the school official or office responsible for issu-ing official academic records. Photocopied, faxed, or scanned records are not accepted. Documents not issued in English by the institu-tion must be accompanied by complete, literal English translations certified by the institution or qualified translation service. Former University of Iowa students do not need to send a UI transcript or other transcripts previously sent to the university. Credentials submitted for admission become the property of the university and are not returnable or transferable.

C2. GRE—Many graduate programs require the Graduate Record Examination. Information concerning this requirement will be in your department’s information (grad.admissions.uiowa.edu/graduate-areas-of-study). If your department requires the test, scores must be on file before a decision can be made. Official score reports must come directly from Educational Testing Service (ETS). The University’s GRE code is 6681. For information, go to www.gre.org.

C3. GMAT—The Graduate Management Admission Test (GMAT) is required for some programs in business. The university’s GMAT code is 4RL–2J–98. For information, go to www.gmac.com.

C4. TOEFL—The Test of English as a Foreign Language (TOEFL) is required of all international applicants who are non-native speakers of English. This requirement is automatically waived for applicants who have completed a bachelor’s degree (or higher) at an accredited university in the United States, the United Kingdom, Canada (excluding French Quebec), Africa (English-speaking), Australia, or New Zealand. The university’s TOEFL code is 6681. For information, go to www.toefl.com.

As an alternative to the TOEFL, an International English Language Testing System (IELTS) total score of 7.0 (with no subscore less than 6.0) may be used to satisfy the English-language requirement. All IELTS test takers will be required to take the on-campus English Proficiency Evaluation.

Admission to the college requires a score of 550 or higher on the paper-based (PBT) version of the TOEFL, or a score of 81 on the Internet-based test (IBT). Newly admitted graduate students who present TOEFL scores below 600 on the PBT (or below 100 on the IBT), are required to complete an English Proficiency Evaluation on campus before their first registration for classes. Some departments may require students to complete an English Proficiency Evaluation, regardless of their TOEFL score. Students are required to complete any English as a Second Language course work (typically within the first year of study) specified as a result of the English Proficiency Evaluation. There is no conditional admission for graduate students whose TOEFL scores are below 550 on the PBT (or below 81 on the IBT).

D. Departmental InformationD1. Letters of Recommendation—These persons should be acquainted with the scope and quality of your academic achievements and should be able to address your ability to complete a graduate degree at the University of Iowa. Ask your recommenders to use your full name as it appears on your application.

D5. Cumulative GPAs—For example, 3.22 on a 4.00 scale. If your institution did not use a 4.00 grading scale, provide your overall grade average and the scale used (e.g., 8.5 on a 10-point scale; 65% on a 100 scale; Second Class First Division).

G. Statement in Determination of ResidencyThe classification of residents and nonresidents for admission and tuition purposes is based upon information furnished by you. The registrar is authorized to require additional evidence as deemed necessary to verify your status. Address questions to the Office of the Registrar, 311 Calvin Hall, 319-335-0223.

H. Supplemental Application Information for International StudentsThis section is to be completed by international applicants only. The information you give us will be reported to SEVIS. Federal guidelines require that you provide a permanent foreign home address. This is the address you will return to when you finish your studies in the United States.

I. CertificationYour signature verifies that all information contained in your application is factually correct and complete.

International students, in addition, are verifying that they understand that the purpose of Item J—Financial Statement for International Applicants is to prevent financial difficulties after enrolling in the university, that the university cannot be expected to provide financial assistance, and that health and accident insurance is required.

Graduate Programs at Iowacode program name .......................................................... degree(s) offered ...........campus address ........ local phone ................email address (area code 319)

06A Accounting*** .....................................................................MAc**, PhD ...........W252 PBB ................335-0913 ....................accounting@uiowa.edu22T Actuarial Science*** .........................................................................MS* ........... 241 SH ......................335-2082 ....................actuarial-science@uiowa.edu134 African American World Studies ..................................................... MA* ........... 310 EPB ....................335-0454 ....................afam-world-studies@uiowa.edu045 American Studies ....................................................................MA*, PhD ........... 210 JB .......................335-0320 ....................american-studies@uiowa.edu060 Anatomy & Cell Biology ..................................................................PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu113 Anthropology .........................................................................MA*, PhD ........... 114 MH ....................335-0522 ....................anthropology@uiowa.edu22A Applied Mathematical & Computational Sciences ...........................PhD ........... 14 MLH ....................335-0708001 Art ........................................................................................ MA*, MFA ........... 1022 SA .....................335-1758 ....................art@uiowa.edu01H Art History .............................................................................MA*, PhD ........... 1022 SA .....................335-1758 ....................art@uiowa.edu39C Asian Civilizations ........................................................................... MA* ........... 111 PH ......................335-2245 ....................asian-slavic@uiowa.edu29A Astronomy .......................................................................................MS* ........... 203 VAN ...................335-1687 ....................admissions@newton.physics.uiowa.edu099 Biochemistry ............................................................................ MS, PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu02A Biology ....................................................................................MS*, PhD ........... 142 BB ......................335-1092 ....................biology-admissions@uiowa.edu156 Biosciences Program .........................................................................PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu171 Biostatistics .............................................................................MS*, PhD ........... 334 CPHB ................384-1541 ....................biostatistics@.uiowa.edu108 Book Arts ........................................................................................MFA ........... 216 NH .....................335-0447 ....................center-for-the-book@uiowa.edu004 Chemistry ...............................................................................MS*, PhD ...........E227 CB....................335-2805 ....................chem-dept@uiowa.edu043 Classics ................................................................................. MA**, PhD ........... 210 JB .......................335-2323 ....................classics@uiowa.edu194 Clinical Investigation .......................................................................MS* ........... SW44E GH ...............384-5365036 Communication Studies .........................................................MA*, PhD ........... 105 BCSB .................335-0576 ....................commstudies-inquiry@uiowa.edu172 Community & Behavioral Health ............................................ MS, PhD ...........N470 CPHB .............384-149048C Comparative Literature ....................................................................PhD ...........E210 AJB ..................335-0330 ....................cinema-complit@uiowa.edu48L Comparative Literature–Translation ................................................MFA ...........E210 AJB ..................335-0330 ....................cinema-complit@uiowa.edu22C Computer Science .....................................................MCS**, MS*, PhD ........... 14 MLH ....................335-0707 ....................cs_info@cs.uiowa.edu137 Dance ..............................................................................................MFA ...........E114 HH ..................335-2621 ....................dance@uiowa.edu 11D Dental Public Health ......................................................................... MS ...........N-329 DSB ...............335-7183 ....................dental-prevcomm@uiowa.edu65D Dietetic Internship Program .................................................................PI ...........W146 GH .................353-699706E Economics ........................................................................................PhD ...........W288 PBB ................335-0830 ....................econphd@uiowa.edu07P Ed: Counseling Psychology*** ..........................................................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07C Ed: Counselor Education and Supervision*** ...................................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07D Ed: Educational Administration*** ...........................MA**, EdS**, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07P Ed: Educational Measurement & Statistics*** ........................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07P Ed: Educational Psychology*** ...............................................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07E Ed: Elementary*** ..................................................................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07E Ed: Elem/Curriculum & Supervision*** .................................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07E Ed: Elem/Language, Literacy & Culture*** ......................................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07E Ed: Elem/Developmental Reading*** .............................................. MA* ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07H Ed: Higher Education & Student Affairs*** ..............MA**, EdS**, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07C Ed: Marital & Family Therapy .........................................................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07C Ed: Rehabilitation & Mental Health Counseling*** .......................MA** ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07C Ed: Rehabilitation Counselor Education ..........................................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07C Ed: School Counseling*** ............................................................... MA* ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07D Ed: School Curriculum & Assessment Policy*** .............................EdS** ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07P Ed: School Psychology*** ..................................................... EdS**, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07R Ed: Science ................................................................. MS, MAT**, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Art*** ......................................................................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Curriculum & Supervision*** ........................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Developmental Reading*** ..................................... MA* ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–English*** ................................................ MA**, MAT** ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Foreign Language & ESL ......................MA, MAT, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Language, Literacy & Culture*** .............................PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Mathematics***............................................ MA**, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07S Ed: Secondary–Social Studies*** ............................................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu07F Ed: Social Foundations*** ......................................................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu

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code program name .......................................................... degree(s) offered ...........campus address ........ local phone ................email address (area code 319)

07U Ed: Special*** .........................................................................MA*, PhD ...........N310LC ....................335-5260 ....................coe-tess@uiowa.edu531 Engineering/Biomedical ..........................................................MS*, PhD ........... 1402 SC ....................384-0671 ....................bme@engineering.uiowa.edu532 Engineering/Chemical & Biochemical ....................................MS*, PhD ........... 4133 SC ....................335-1215 ....................chemeng@engineering.uiowa.edu533 Engineering/Civil & Environmental........................................MS*, PhD ........... 4105 SC ....................335-5647 ....................cee@engineering.uiowa.edu535 Engineering/Electrical & Computer ........................................MS*, PhD ........... 4016 SC ....................335-5197 ....................ece@engineering.uiowa.edu536 Engineering/Industrial.............................................................MS*, PhD ........... 3131 SC ....................335-5668 ....................indeng@engineering.uiowa.edu538 Engineering/Mechanical ..........................................................MS*, PhD ........... 3131 SC ....................335-5668 ....................mech_eng@engineering.uiowa.edu08C English/Creative Writing .................................................................MFA ........... 102 DH .....................335-0416008 English/Literary Studies .........................................................MA*, PhD ........... 308 EPB ....................335-0440 ....................english@uiowa.edu08N English/Nonfiction Writing .............................................................MFA ........... 308 EPB ....................335-0440 ....................nonfiction-writing-program@uiowa.edu173 Epidemiology ..........................................................................MS*, PhD ........... S408 CPHB...............384-1544 ....................cph-graduateprograms@uiowa.edu27B Exercise Science ................................................................................MS* ...........E102 FH ...................335-9335 ....................integrative-physiology@uiowa.edu48V Film & Video Production ...................................................... MA*, MFA ...........E210 AJB ..................335-0330 ....................cinema-complit@iowa.edu48F Film Studies ...........................................................................MA*, PhD ...........E210 AJB ..................335-0330 ....................cinema-complit@iowa.edu06F Finance*** ........................................................................................PhD ...........W288 PBB ................335-0830 ....................tippie-phd@uiowa.edu077 Free Radical & Radiation Biology ...........................................MS*, PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu009 French & Francophone World Studies ...................................MA*, PhD ........... 111 PH ......................335-2245 ....................french-italian@uiowa.edu127 Genetics ...........................................................................................PhD ........... 353 MRC ..................385-8306 ....................biosciences-admissions@uiowa.edu044 Geography .............................................................................MA*, PhD ........... 316 JH ......................335-0150 ....................geography@uiowa.edu012 Geoscience ..............................................................................MS*, PhD ........... 121 TH .....................335-1819 ....................geology@uiowa.edu013 German ........................................................................................... MA* ........... 111 PH ......................335-2245014 Greek .............................................................................................MA** ........... 210 JB .......................335-2323 ....................classics@uiowa.edu028 Health & Sport Studies .....................................................................MA ...........E102 FH ...................335-9335 ....................clas-hhp@uiowa.edu174 Health Management & Policy .....................................................MHA** ...........N218 CPHB .............384-3817 ....................cph-hmpgradcoord@uiowa.edu192 Health Services & Policy ..................................................................PhD ...........N218 CPHB .............384-3817 ....................cph-hmpgradcoord@uiowa.edu016 History ...................................................................................MA*, PhD ........... 280 SH ......................335-2308198 Human Toxicology ................................................................... MS, PhD ........... 219 IREH ..................335-8306 ....................larry-robertson@uiowa.edu148 Immunology ....................................................................................PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu200 Informatics ..............................................................................MS*, PhD ........... 3087 LIB ...................335-5710 ....................igpi@uiowa.edu27G Integrative Physiology ......................................................................PhD ...........E102 FH ...................335-9335 ....................clas-hhp@uiowa.edu287 International Studies ....................................................................... MA* ........... 1111UCC .................335-1182 ....................ip-capsadmin@uiowa.edu19J Journalism ....................................................................................... MA* ...........E305 AJB ..................335-3401 ....................sjmc-grad@uiowa.edu020 Latin ..............................................................................................MA** ........... 210 JB .......................335-2323 ....................classics@uiowa.edu169 Leisure Studies ................................................................................ MA* ...........E101 FH ...................335-9335021 Library & Information Science ........................................................ MA* ........... 3087 LIB ...................335-5709 ....................slis@uiowa.edu103 Linguistics ..............................................................................MA*, PhD ........... 169 EPB ....................335-0203 ....................linguistics@uiowa.edu06J Management & Organizations*** ....................................................PhD ...........W288 PBB ................335-0830 ....................tippie-phd@uiowa.edu06K Management Sciences*** ..................................................................PhD ...........W288 PBB ................335-0830 ....................tippie-phd@uiowa.edu06M Marketing*** ....................................................................................PhD ...........W288 PBB ................335-0830 ....................tippie-phd@uiowa.edu19M Mass Communication ......................................................................PhD ...........E305 AJB ..................335-3401 ....................journalism-admin@uiowa.edu22M Mathematics ............................................................................MS*, PhD ........... 14 MLH ....................335-0708 ....................vanark@math.uiowa.edu061 Microbiology ....................................................................................PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu142 Molecular and Cellular Biology ........................................................PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu072 Molecular Physiology & Biophysics.........................................MS*, PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu025 Music ................................................................MA*, MFA, DMA, PhD ........... 130 CSM5 .................335-1604 ....................music-admissions@uiowa.edu132 Neuroscience ....................................................................................PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu196 Nursing ......................................................................MSN*, DNP, PhD ........... 37 NB .......................335-7021 ....................nursing-graduateprogram@uiowa.edu175 Occupational & Environmental Health.................................... MS, PhD ........... S365 CPHB...............335-4558082 Operative Dentistry ........................................................................... MS ........... S-229 DSB ................335-7207151 Oral Science ............................................................................. MS, PhD ...........N-406A DSB .............335-7387089 Orthodontics ..................................................................................... MS ........... S-219 DSB ................335-7288069 Pathology .......................................................................................... MS ........... 147 MRC ..................335-8193 ....................pathology-plc@uiowa.edu071 Pharmacology ........................................................................... MS, PhD ........... 353 MRC ..................335-8306 ....................biosciences-admissions@uiowa.edu146 Pharmacy ................................................................................MS*, PhD ........... 118 PHAR .................335-8797026 Philosophy .............................................................................MA*, PhD ........... 169 EPB ....................335-0495 ....................philosophy-dept@uiowa.edu

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code program name .......................................................... degree(s) offered ...........campus address ........ local phone ...............email address (area code 319)

182 Physical Rehabilitation Science .........................................................PhD ........... 1-252 MEB ...............335-6651 ....................physical-therapy@uiowa.edu101 Physical Therapy ..........................................................................DPT** ........... 1-252 MEB ...............335-9792 ....................physical-therapy@uiowa.edu29P Physics ....................................................................................MS*, PhD ........... 203 VAN ...................335-1687 ....................admissions@newton.physics.uiowa.edu030 Political Science ......................................................................MA*, PhD ........... 341 SH ......................335-2359 ....................polisci@uiowa.edu031 Psychology ...................................................................................... PhD ...........E-11 SSH ..................335-2450 ....................psychology@uiowa.edu170 Public Health ..............................................................................MPH** ........... S259 CPHB...............384-1539 ....................cph-graduateprograms@uiowa.edu032 Religious Studies ....................................................................MA*, PhD ........... 314 GILH .................335-2164 ....................religion@uiowa.edu164 Second Language Acquisition ...........................................................PhD ........... 1111M UCC .............335-2825 ....................flare@uiowa.edu042 Social Work .........................................................................MSW*, PhD ........... 308 NH .....................335-1255034 Sociology ................................................................................MA*, PhD ...........W-140 SSH ...............335-2502 ....................sociology@uiowa.edu035 Spanish ...................................................................................MA*, PhD ........... 111 PH ......................335-2245 ....................spanish-portuguese@uiowa.edu35A Spanish Creative Writing .................................................................MFA ........... 111 PH ......................335-2245 ....................spanish-portuguese@uiowa.edu03H Speech & Hearing Science................................................................PhD ........... 353 MRC ..................335-8306 ....................speech-path-aud@uiowa.edu003 Speech Pathology & Audiology ...........................................MA*, AuD** ........... 119 SHC ...................335-8719 ....................speech-path-aud@uiowa.edu22B Statistics ..................................................................................MS*, PhD ........... 241 SH ......................335-2082 ....................statistics@uiowa.edu049 Theatre Arts .....................................................................................MFA ........... 107 TB ......................335-2700 ....................theatre@uiowa.edu163 Translational Biomedicine .....................................................MS**, PhD ........... SW44E GH ...............384-5365102 Urban & Regional Planning ................................................... MA*, MS* ........... 347 JH ......................335-0041 ....................urban-planning@uiowa.edu

*degree offered with or without thesis **nonthesis degree ***subarea

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Application for Graduate Admission — Items A–BPlease read the instructions carefully before completing this page. Apply online at grad.admissions.uiowa.edu/apply.

Submit one copy to the Office of Admissions, 107 Calvin Hall, and submit one copy to your academic department.

A. Personal Information 1. Name (see instruction items A1)

last name (family or surname) first name (given) middle

2. Other name(s), if any, that may appear on transcripts, scores, etc.

3. Gender ❏ male ❏ female ❏ transgender

4. Country of citizenship

List current immigration status, if applicable (see instruction item A4)

Which immigration status do you intend to hold while enrolled here?

5. Citizenship: ❏ U.S. citizen; ❏ U.S. permanent resident (attach a copy of your Permanent Resident Card); ❏ other:

6. U.S. social security number (see instruction item A6) __________________________________________________ 7. Birthdate (Western calendar) month/day/year

8. Birthplace city state country

9. Telephone home cell alternate

10. Do you authorize the University of Iowa to send you text messages about important information and deadlines? ❏ yes ❏ no

11. Email (if available)

12. Racial/Ethnic/Tribal Information (optional—see instruction item A12) Are you Hispanic/Latino(a) ❏ yes ❏ no What race do you consider yourself to be? (indicate one or more) ❏ Alaskan Native or American Indian (Tribal/Nation Affiliation):

❏ African American/Black ❏ Native Hawaiian or Other Pacific Islander ❏ Asian ❏ White ❏ I prefer not to respond

13. Are you currently serving in the military or a U.S. veteran? ❏ yes ❏ no

14. Current mailing address (see instruction item A14) 15. Home (permanent) address, if different (see instruction item A15)

B. Admission Information 1. For which session are you applying? (choose one and note year—see instruction item B1)

❏ Fall (August) 20 ____ ❏ Winter (interim) 20 ____ ❏ Spring (January) 20 ____ ❏ Summer (May/June) 20 ____

2. List your intended department or graduate program of study. (see instruction item B2)

program code

3. Indicate your area of interest or specialization (if applicable).

4. Indicate your intended degree objective. (see instruction item B4) ❏ MPH ❏ MHA ❏ MCS ❏ AuD ❏ DNP ❏ MA/thesis ❏ MA/nonthesis ❏ MSW ❏ MAc ❏ MSN ❏ MFA ❏ MAT ❏ Certificate ❏ DPT ❏ MS/thesis ❏ MS/nonthesis ❏ EdS ❏ PhD ❏ DMA ❏ Professional Improvement

5. If applying for a master’s degree, do you plan to continue in a doctoral program at this university? ❏ yes ❏ no

6. List any University of Iowa faculty with whom you have discussed your plans.

7. Have you applied for admission to a UI graduate program within the last year? ❏ yes ❏ no If yes, for which session did you apply?

❏ Fall (August) 20 ____ ❏ Winter (interim) 20 ____ ❏ Spring (January) 20 ____ ❏ Summer (May/June) 20 ____

office use only

GY

Pre-ad HC RES FOR FS CO ST FEE Org Y/S COL AG RefCd

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Application for Graduate Admission — Items C–F

Name (repeat what you listed for item A1) last name (family or surname) first name (given) middle

U.S. social security number (repeat what you listed for item A6)

C. Educational Information (see instruction item C) 1. List chronologically all postsecondary institutions you have attended or in which you are presently enrolled. name of institution location of institution dates attended degree earned date degree earned/expected office use only

2. I ❏ plan to take/❏ took the GRE month

/year

My scores are: V _____ Q _____ A _____ Analyt. Writ. _____ Subj. Text _____ Subj. Score _____

3. I ❏ plan to take/❏ took the GMAT month

/year

My scores are: V _____ Q _____ Total _____ AWA _____

4. I ❏ plan to take/❏ took the TOEFL month

/year

Test type: Paper _____ Internet _____

My scores are: Listening_____Writing_____ Reading_____ Speaking (if applicable) _____ Total ______

5. I ❏ plan to take/❏ took the IELTSmonth

/year

My scores are: Listening_____Reading_____Writing_____ Speaking _____ Overall ______

D. Departmental Data 1. List the three people you are asking to write letters of recommendation. Have these letters addressed and mailed to your

proposed department of study. (see pages 4–6 for campus address, The University of Iowa, Iowa City, IA 52242) name title/position address phone number

___________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________

2. List your undergraduate major field of study. ________________________________________________________________________________

3. List your undergraduate minor field of study (if any). _________________________________________________________________________

4. List your graduate major field of study (if applicable). _________________________________________________________________________

5. Provide your undergraduate and graduate cumulative grade-point average (GPA) and grading scale. (see instruction item D5)

Undergraduate GPA: ____________________on a _________________ scale; Graduate GPA: _______________ on a _____________scale.

6. Describe any research you have completed.

7. In what area(s) would you like to do research?

8. For what career are you preparing?

9. List relevant work or teaching experience: job title employer dates (month/year to month/year)

10. List the titles of any articles, publications, inventions, or creative work you have completed.

11. Is English your first language? ❏ Yes ❏ No If no, what is your first language?

12. Describe the preparation and proficiency you have in other languages (please be specific).

13. List the academic honors, prizes, or awards you have received.

14. List any professional licensure(s).

15. List your participation in any extracurricular activities.

16. List any organizations or community activities in which you have been active.

17. Statement of Disclosure for Nursing Applicants (required for nursing applicants)

• Have you ever been charged with or convicted of any felony or misdemeanor (other than minor traffic violations) including juvenile charges, deferred prosecutions/judgments, and expunged convictions? ❏ Yes ❏ No

If yes, please explain using a separate sheet of paper and attach to your application.

• Have you ever been investigated for child or dependent abuse or neglect? ❏ Yes ❏ No

If yes, please explain using a separate sheet of paper and attach to your application.

E. Statement of Purpose (Write on a separate sheet and attach to this page.)

Your statement should include your purpose in pursuing graduate study, any research you wish to pursue, and your future career goals.

F. Additional Supporting Information (optional)

If you believe that your academic record or test scores do not accurately reflect your ability to do graduate work, you may wish to attach a statement to this page that describes additional factors that you feel merit consideration. Examples might be: experiences that indicate unusual determination, motivation, or leadership characteristics; adverse conditions (e.g., illness); obligations (e.g., employment); or cultural, linguistic, or economic factors.

Submit this to your academic department.

Name (repeat what you listed for item A1) last name (family or surname) first name (given) middle

U.S. social security number (repeat what you listed for item A4) _____________________________________________________________________________

G. Statement in Determination of Residency (see instruction item G)

1. Do you consider yourself a resident of the state of Iowa? ❏ yes ❏ no If yes: a) When did your residency begin? month/year

b) In which county (if within the state of Iowa) do you reside?

c) List the high school from which you graduated school name city state year graduated

d) Parent name

e) Parent address street city state/country

2. Give a chronological account of your major activities (including summer activities) for the three years immediately preceding your proposed entry to the University of Iowa Graduate College. List most recent activities first and be as specific as possible (e.g. work at ACT; school at Cornell University)

from (mo/yr) to (mo/yr) activity (i.e., employment, school, military) location (city/state)

H. Supplemental Application Information for International Students (see instruction item H)

1. Country of legal permanent residence (if your country of citizenship differs from your country of legal permanent residence):

2. Permanent foreign home address:

I. CertificationI certify that all information contained in this application is factually correct and complete. I understand that the omission or misrepresentation of any information, including enrollment in other colleges or universities, may void my admission or result in dismissal.

signature of applicant date

The University of Iowa requests this information for the purposes of processing your application for admission. Persons outside the university are not routinely provided this information except for directory information, such as name and local address. Although responses to application items marked “optional” are optional, responses to all other items are required in order for us to take action.

Application for Graduate Admission — Items G–IPlease read the accompanying instructions carefully before completing this page.

Submit this to the Office of Admissions • The University of Iowa • 107 Calvin Hall • Iowa City, IA 52242-1396 • USA

• continue •

J. Financial Statement for International Applicants (see instruction item J)

Once recommended for admission, applicants from other countries must submit evidence of adequate support to cover the costs of one full year of study at the University of Iowa before a Certificate of Eligibility (I-20 or DS-2019) will be issued.

Please read the accompanying instructions carefully before completing this page.

Name last name (family or surname) given name(s)

Student identification number (if known) _________________________________ Date of birth month/day/year

Amount in U.S. Dollars Available from Each of Your Financial Resources

$

a) Personal funds (attach an original financial statement signed by a bank official showing your current bank balance and the date and amount of your most recent deposit)

name of bank city country

$

b) Family or sponsor funds from sponsor’s name relationship to you

(Attach an original bank statement. Sponsors agree to provide the stated amount for the first year, payable in U.S. dollars.)

sponsor’s name (please print) sponsor’s signature (required) date

sponsor’s address city

state/province country ZIP/postal code

$

c) Scholarships, grants, or loans (Attach a copy of the award letter and specify the name and address of each source below. Do not include funding from the University of Iowa here.)

_______________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________

$

d) From your salary while on leave of absence (attach a statement from your employer)

$

e) University of Iowa teaching/research assistantship/scholarship (attach a copy of the award letter from your department)

$

f ) Funding from another source (specify type, source, and address of each source below and attach verification)

_______________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________

Application for Graduate Admission — Item J (Do not complete this section if you are a U.S. citizen or permanent resident.)

Students who wish their spouse or child to accompany them to Iowa City on F-2 or J-2 visas must submit additional evidence of adequate financial support for their dependents’ living expenses and health insurance costs.

Estimated Annual Living Expenses*Spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3,200

Each child. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2,500

Annual Insurance Costs* International students with 1/4–time or greater graduate assistantships

International students without assistantships

Student & spouse $1,624 $6,480

Student, spouse, & child(ren) $3,136 $11,040

Student & child(ren) $3,996 $7,680

*Figures quoted are subject to increase without notification.

Information Regarding DependentsThe following information is needed to issue immigration documents for your family members for the purpose of obtaining F-2 or J-2 visas. List all dependent family members (if any) who will accompany you to Iowa City. Do not list family members who are not your dependents (such as parents, cousins, siblings). List names and dates of birth as they will appear on the family member’s passport. (Use a separate sheet if more than three dependents will accompany you.)

Family Member #1 Family Member #2 Family Member #3

surname (family name): surname (family name): surname (family name):

given name(s): given name(s): given name(s):

date of birth (mm/dd/yy): date of birth (mm/dd/yy): date of birth (mm/dd/yy):

city and country of birth: city and country of birth: city and country of birth:

country of citizenship: country of citizenship: country of citizenship:

country of legal permanent residence: country of legal permanent residence: country of legal permanent residence:

relationship to you: relationship to you: relationship to you:

Submit this to the Office of Admissions • The University of Iowa • 107 Calvin Hall • Iowa City, IA 52242-1396 • USA

Students with Dependents