Franklin University Graduate Application Form
1. Personal Details
Title:
Mr
Mrs
Miss
First Name
Last Name
Gender:
Male
Female
Other
Date of Birth (dd/mm/yyyy)
2. Contact Details
Building Name
Flat/Unit Number
Street Number
Street Name
Suburb/Town
State
Country
Zip/Postcode
Mobile Phone Number
Home Telephone Number
Email Address
3. Emergency Contact Details
Full Name
Relationship
Street Number
Street Name
State
Country
Zip/Postcode
Mobile Phone Number
Home Telephone Number
Email Address
4. Nationality / Citizenship Details
Ethnicity:
Hispanic or Latino
Not Hispanic or Latino
Race (choose one or more):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other (specify below)
Country of Citizenship
Country of Birth
Native Language
5. Program of Choice
Program:
MBA
M.S. Computer Science
M.S. in Information Technology
M.S. in Business Analytics
M.S. in Health Informatics
Intake Term:
Fall
Spring
Summer
Application Type
International
Transfer
6. English Language Proficiency
Test Name
Overall Score
Listening Score
Reading Score
Writing Score
Speaking Score
7. Employment Status
Employment Status:
Employed
Unemployed
Self-Employed
Retired
8. Work Experience
Organization 1
Employment Dates 1
Organization 2
Employment Dates 2
Organization 3
Employment Dates 3
9. Academic History
College/University 1
Location 1
Degree Awarded 1
Date Awarded 1
GPA 1
College/University 2
Location 2
Degree Awarded 2
Date Awarded 2
GPA 2
10. Standardized Tests (GRE)
Verbal Score
Quantitative Score
Analytical Score
Date Taken
Anticipated Test Date
11. Student Conduct
Felony Conviction:
Yes
No
Disciplinary Violation:
Yes
No
12. Recommenders
Recommender 1
First Name
Last Name
Designation
Organization
Email Address
Recommender 2
First Name
Last Name
Designation
Organization
Email Address
Recommender 3
First Name
Last Name
Designation
Organization
Email Address
13. Agent’s Declaration and Details
I have assessed the applicant as a genuine student .
The applicant is genuine in making this application and has every intention of completing all courses listed in the application and has sufficient funds to complete the courses.
I have made every effort to verify the authenticity and validity of the documents which form part of this application
14. Applicant’s Checklist (Tick all you have completed)
All details in the application form are filled in correctly
Application is signed and dated
All attached documents are verified by agent or certified
Documents Attached:
Passport copy
Proof of English Proficiency
Academic Documents (Certificates, Transcripts, Statements)
Work Experience Letters
Applicant Signature
Application Date
Submit Application