Date: 

Application for Term Beginning: 

First Name:   MI:   

Last/Family Name: 


Present Address:
 
Street: 

City:   State:   Postal Code: 

Country:   Phone: 


Permanent Address:

Street: 

City:   State:   Postal Code: 

Country:   Phone: 


Email Address: 

Gender:  Male    Female

Resident of Florida:  Yes    No

Citizenship: 

If non-US, Permanent Resident?  Yes    No

Ethnic Origin, check one: 
(Requested in compliance with Title VI of the Civil Rights Act of 1964)
 White (not of Hispanic origin)
 Black (not of Hispanic origin)
 Hispanic
 Asian or Pacific Islander
 American Indian or Native American



Degree Sought:  MS    PhD

Undergraduate Record:

Institution
Attended

Dept. and/or
Major

Date
Entered

Date
Left

Degree
Received

Grade Point Average (GPA) for all work attempted in Junior and Senior years: 
(A=4, B=3, C=2, D=1, F=0)
 for  hours.


Graduate Record:

Institution
Attended

Dept. and/or
Major

Date
Entered

Date
Left

Degree
Received

Grade Point Average (GPA) for all work attempted: 
(A=4, B=3, C=2, D=1, F=0)
 for  hours.

Graduate Record Exam (GRE):
Verbal:   Quantitative:   Analytical:   Date taken: 

TOEFL:   (Required for foreign students)   Date taken: 

TSE:   (Required for International Students requesting assistance)  Date taken: 

Academic Honors Received:



DO YOU WISH TO BE CONSIDERED FOR A GRADUATE ASSISTANTSHIP OR FELLOWSHIP?
 Yes    No

Be sure to consult the departmental Graduate Degree Information on the web to find the minimum eligibility requirements for any type of departmental financial assistance. Applications for teaching assistantships or fellowships must be in by March 5.

Names of three persons whom you have asked to send letters of recommendation.
Please check to see that they get here on time.
1. 
2. 
3. 


1a. Is English your native language? 
     Yes    No
    If yes, go to 2.

1b. If your answer is no, Have you studied within the United States for one year or more?
     Yes    No
    If yes, go to 2.

1c. If your answer to both questions is no, then we need an official 
    copy of your TOEFL scores. (NOTE: You must have TOEFL scores of at least 550 
    to be admitted into Florida State University).
 
    Describe your training and experience with English.

    

2.  Describe any relevant computer-related course work and experience, 
    and all the programming languages that you know.

    

3.  List any teaching experience.

    

4.  Give a statement of your interests, career goals, and reasons
    for wanting to attend FSU. (250 words maximum)

    

5.  Give a supporting statement if you wish special consideration as a 
    member of a native racial or ethnic minority.

    


For those that download, print and mail the application, please sign and date:


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Signature			Date