Application for Graduate Admission Part A

Please complete the following preliminary application. Once you have completed this form, you will be directed to instructions on how to submit your $50 application fee and to complete Part B of your graduate application.

Program and Location Information
Select your desired program *
Select your preferred location of study *
List specific campus:
Select your preferred start term
Applicant Information
First Name *
Middle Name *
Last Name *
Marital Status
Maiden Name (if coursework was completed in a different name)
Date of Birth * / MM / DD YYYY
Gender * Male Female
Permanent Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Mailing Address (if different than above)
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone * - (###) - ### ####
Work Phone - (###) - ### ####
Cell Phone - (###) - ### ####
Home E-mail Address (or most frequently used) *
Work E-mail Address
Ethnicity
International Student Information
Are you an International student? If yes, our Admissions team will contact you with additional instructions. * Yes No
Veteran Information
Are you a U.S. Veteran? * Yes No
Employer Information
Name of Employer
Your Title/Position
Employer Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Educational Background
You must submit official transcripts from all prior colleges or universities. Once you have completed this application, you will be able to download the transcript request form. This form may be duplicated as needed.
In the box below, please specify the name, city and state, dates attended, and degrees earned for each prior college/university. *
Additional Information
Have you ever been convicted of a crime (felony or misdemeanor) in any state or country? * Yes No
Have you ever been dismissed from an institution of higher learning for academic reasons? * Yes No
Have you ever been dismissed from an institution of higher learning for disciplinary reasons? * Yes No
How did you hear about us?
Other
By submitting this application, I agree to comply with the policies and regulations of Keuka College, and grant the College permission to use my photograph and name in College literature, on the College Web site, and for public relations purposes. My submission indicates that all information on my application is complete, factually correct and honestly presented. I understand that misrepresentation of facts on this application will be cause for refusal of admission, cancellation of admission, or suspension from the institution.

Application for Graduate Admission Part A

Application for Graduate Admission Part A

Program and Location Information

Applicant Information

International Student Information

Veteran Information

Employer Information

Educational Background

You must submit official transcripts from all prior colleges or universities. Once you have completed this application, you will be able to download the transcript request form. This form may be duplicated as needed.

Additional Information