TRADITIONAL UNDERGRADUATE PROGRAM Second Major Application For Admission

TRADITIONAL UNDERGRADUATE
PROGRAM
Second Major
Application For Admission
Main Campus: 5700 College Road, Lisle, Illinois 60532
Enrollment Center Phone: (630) 829-6300
Outside Illinois: (888) 829-6363
Email: [email protected]
FAX: (630) 829-6301
Web Address: ben.edu
Application fee waiver code
ADM staff approval
Date
2014-2015
APPLICATION INFORMATION
This program is designed for persons who already have a degree
in one area and would like to gain expertise in another major. The
courses focus on the requirements in the new major. Second Major
students are not eligible for financial aid.
Second Major Program students must:
1. Submit an official transcript indicating completion of a bachelors
degree, from an institution which was an accredited four year
college, in a major different from the new one being sought;
2. Select one of the University’s major programs and complete all
requirements for that major as listed in the catalog which is in effect
at the time of admission to the program. (If a student enters the
program the first semester after graduation from Benedictine
University, then the requirements in effect will be those in the
catalog of the original term of entry);
3. Enroll for at least one course in the major each semester, or have
a valid Leave of Absence form on file; and
4. Complete all work on the Second Major within seven years of
admission to the program.
Life experience credit, transfer and CLEP exam credit may be counted
toward the program requirements, if appropriate, as determined
by each department. However, at least 12 hours of 200/300-level
classroom courses must be completed at Benedictine University.
Applicability of courses taken as a Student-At-Large prior to admission
to the Second Major Program will be determined upon admission to
the program.
Courses taken in the Second Major Program are applicable to a second
bachelors degree for graduates of other colleges. Those courses will
also be counted toward the second degrees residency requirement.
Upon completion of the program a notation on the transcript will
be made that all requirements for a second major have been met.
A certificate will also be awarded.
Students with a documented physical or mental disability may be
eligible for special accommodations through the Americans with
Disabilities Act. Please contact the Student Success Center for
more information.
GENERAL INFORMATION
LAST NAME
OTHER NAMES
FIRST
MIDDLE
HOME/CELL TELEPHONE
MAIDEN (IF ANY)
DAYTIME TELEPHONE
STREET ADDRESS
SOCIAL SECURITY NUMBER
CITY
STATE EMAIL ADDRESS
COUNTY
MARITAL STATUS
r SINGLE
9-DIGIT ZIP CODE
r MARRIED
r MALE
r FEMALE
r OTHER
RELIGION
DATE OF BIRTH (MM/DD/YY)
ETHNICITY
Is English the primary language spoken in the home? r Yes r No
If no, please state language _______________________________________
Have you ever pleaded “guilty” or “no contest” to, or been convicted of, a felony?
r No
r Yes
If yes, please provide date(s) and details_______________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________
ANSWERING YES DOES NOT CONSTITUTE AN AUTOMATIC BAR TO ADMISSION. FACTORS SUCH AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION AND
REHABILITATION WILL BE TAKEN INTO ACCOUNT. NOTE: YOU ARE NOT OBLIGATED TO DISCLOSE THE EXISTENCE OF ANY CONVICTION OR ARREST RECORDS WHICH HAVE BEEN
SEALED OR EXPUNGED PURSUANT TO CHAPTER 20, SECTION 2630/12 OF THE ILLINOIS COMPILED STATUTES.
EDUCATIONAL HISTORY
NAME OF HIGH SCHOOLMONTH/YEAR OF HIGH SCHOOL GRADUATION OR GED
IMPORTANT: FAILURE TO LIST BELOW ALL SECONDARY SCHOOLS, UNIVERSITIES AND POST-SECONDARY INSTITUTIONS IN WHICH YOU ENROLLED (INCLUDING
CORRESPONDENCE AND EXTENSION COURSES) MAY RESULT IN DELAY IN ADMISSION, LOSS OF TRANSFER CREDIT, AND/OR DISMISSAL. IT IS THE APPLICANT’S
RESPONSIBILITY TO HAVE OFFICIAL TRANSCRIPTS FORWARDED FROM EACH INSTITUTION IN WHICH YOU ENROLLED. AN OFFICIAL TRANSCRIPT IS REQUIRED
EVEN IF ENROLLMENT WAS FOR A BRIEF TIME AND NO CREDIT WAS ESTABLISHED.
NAME(S) OF ALL COLLEGE(S) ENROLLED
LOCATION
DATES ENROLLEDDIPLOMA/DEGREE
(Undergraduate & Graduate Level)(check box if last school attended)
r
r
r
r
r
Will you have a bachelor’s degree completed prior to enrollment at Benedictine University? r No r Yes
I understand that I must disclose all schools enrolled and failure to do so can lead to the denial of admissions, revoking of admission or
administrative withdrawal from course enrollment.
Signature ________________________________________________________________
Have you ever applied for admission to Benedictine University? r No r Yes
Have you ever enrolled at Benedictine University? r No r Yes
If yes, when? ________________________________________
If yes, dates enrolled______________________________________________
If yes, have you attempted any college credit since attending Benedictine University? r No r Yes
Have you ever been suspended, placed on probation or dismissed from any high school or college? r No r Yes
If yes, please explain the following on a separate sheet of paper: date of occurrence, summary of incident, how you were held accountable
(outcomes, sanctions, etc.) and any additional information you wish to provide. Please note: additional information may be requested.
ADMISSIONS INFORMATION
When do you expect to enter Benedictine University? r Fall r Spring r Summer Year __________
I will be a: r Full-Time Student (12 hours or more)
r Part-Time Student (11 hours or less)
On what campus do you plan to attend?
r Lisle
r Springfield
r Other_____________________________________________________
I will be a r Campus Resident r Commuter
How did you hear about Benedictine University?________________________________________________________________________________
Have you visited the Benedictine University campus yet? r No r Yes
TRADITIONAL UNDERGRADUATE ACADEMIC INFORMATION
PLEASE INDICATE CHOICE OF SECOND MAJOR FIELD
College of Business
r Accounting~
r Business Analytics
r Business and Economics#*
rB
usiness with Science
Applications
r Economics
r Finance~
r International Business
and Economics~
rM
anagement and
Organizational Behavior*
r Marketing~
r Undecided Business
College of Education
and Health Services
r Elementary Education+
r Exercise and Sports Studies
r Nutrition~
r Physical Education+
r Special Education^+
rU
ndecided Education
and Health Services
College of Liberal Arts
r Bilingual Journalism
r Communication Arts~
r Criminal Justice
r English Language
and Literature#
r Fine Arts+
r Global Studies~
r Graphic Arts and Design
r History
r International Studies~
r Medical Humanities
r Music
r Music Education+
r Philosophy
r Political Science~
r Psychology~
r Social Science#
r Sociology~
r Spanish#~
r Studio Art
r Theology
r Writing and Publishing
r Undecided Liberal Arts
PRE-PROFESSIONAL HEALTH
PROGRAMS (also select a major)
College of Science
rB
iochemistry/Molecular Biology
r Biology (B.A.)
r Biology (B.S.)#
r Chemistry#
r Clinical Laboratory Science+
r Clinical Life Science –
Perfusion Technology+
r Clinical Life Science –
Respiratory Care+
rC
omputer Information Systems
r Computer Science
rD
iagnostic Medical Sonography+
r Engineering Science
r Environmental Science
r Health Science
r Mathematics#~
r Nuclear Medicine Technology+
r Physics#~
r Radiation Therapy+
rU
ndecided Science
r Pre-Chiropractic
r Pre-Dentistry
r Pre-Medicine
r Pre-Occupational Therapy
r Pre-Optometry
rP
re-Pharmacy
r I am applying to the Dual Acceptance
program with Midwestern University+
r Pre-Physical Therapy
r Pre-Physician Assistant
r Pre-Podiatry
r Pre-Veterinary Medicine
Do you plan to teach?
r No r Yes r Undecided
r Elementary r Secondary
r Special Education
(select one)
r Undecided
Concentration – please specify ________________________________________________ (see catalog, select majors only)
* Concentration is required. (See catalog, select majors only)
~ Concentration is available. (See catalog, select majors only)
#
Teacher certification available
^
Students who wish to teach secondary education must major in a specified subject
+
General admission does not guarantee acceptance into this specific degree program. An additional application process will be required later in this academic program.
I UNDERSTAND THAT I MUST MEET THE DEPARTMENT REQUIREMENTS FOR THIS MAJOR AS LISTED IN THE UNIVERSITY CATALOG WHICH IS IN EFFECT
WHEN I TAKE MY FIRST COURSE. I UNDERSTAND THAT THESE REQUIREMENTS WILL BE IN EFFECT AS LONG AS I ENROLL IN ONE COURSE, APPLICABLE
TO THIS MAJOR, EVERY SEMESTER, OR HAVE A VALID LEAVE OF ABSENCE FORM ON FILE. NOTE: PLEASE NOTIFY THE REGISTRAR THE TERM PRIOR
TO COMPLETION OF THESE REQUIREMENTS. YOUR RECORD WILL BE FORMALLY AUDITED AT THAT TIME. YOU WILL BE AWARDED YOUR SECOND
MAJOR CERTIFICATE AT THE COMPLETION OF ALL MAJOR REQUIREMENTS.
CITIZENSHIP INFORMATION — MUST BE COMPLETED
Are you a U.S. citizen? r No r Yes
If yes, check one: r By birth r By naturalization (naturalization certificate number:____________________________________________________)
If no, are you a U.S. permanent resident/immigrant/green card holder? r No r Yes
If yes, please attach a copy of your permanent residency card.
If you are not a U.S. citizen/permanent resident, then please check the appropriate box to indicate your status in the U.S.:
r Asylum Granted r Indefinite Parole r Conditional permanent resident (I-551C)
r Non-U.S. Citizen r Cuban Haitian Entrant
r Refugee
r Humanitarian Parole
r Other_____________________
If you have checked one of the boxes above, please attach a copy (both sides) of your alien registration card, temporary
resident card or other USCIS document indicating approval of current visa status. If you have checked none of the boxes
above, then please fill out our International Student Application.
EMPLOYER INFORMATION
Are you currently employed?
r No
r Yes
r Full Time
r Part Time
Are you a veteran or currently serving in the U.S. Military? r No r Yes
Are you or have you ever been an employee of Benedictine University? r No r Yes
EMPLOYER/COMPANY NAME
POSITION
TELEPHONE
WORK EMAIL (OPTIONAL)
ADDRESS
CITY
STATE
COUNTY
COUNTRY
ZIP CODE
DESCRIBE YOUR CURRENT JOB RESPONSIBILITIES
_____________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________
Does your employer provide tuition reimbursement? r No r Yes
READ CAREFULLY AND SIGN AS INDICATED
I AGREE TO COMPLY WITH THE REGULATIONS AND REQUIREMENTS OF BENEDICTINE UNIVERSITY, AND TO COOPERATE WITH THE ADMINISTRATIVE
OFFICERS, FACULTY AND MY FELLOW STUDENTS IN MAINTAINING HIGH STANDARDS OF CONDUCT AND SCHOLARSHIP AND IN PROMOTING THE
GENERAL WELFARE OF THE UNIVERSITY. I UNDERSTAND THAT THE UNIVERSITY RESERVES THE RIGHT TO CANCEL THE REGISTRATION OF ANY
STUDENT AT ANY TIME WHATSOEVER FOR REASON OF DEFICIENCY IN SCHOLARSHIP, UNSATISFACTORY CONDUCT, OR FOR ANY OTHER JUST CAUSE.
I AGREE TO PAY ALL FEES IN ADVANCE EACH SEMESTER OR BY SPECIAL ARRANGEMENT WITH THE UNIVERSITY. I CERTIFY THAT THE INFORMATION I
HAVE PROVIDED IS TO THE BEST OF MY KNOWLEDGE CORRECT AND COMPLETE. FAILURE TO PRESENT ACCURATE INFORMATION IN THIS DOCUMENT
CAN LEAD TO THE DENIAL OF ADMISSION, REVOKING OF ADMISSION OR ADMINISTRATIVE WITHDRAWAL FROM COURSE ENROLLMENT. I HEREBY
AUTHORIZE BENEDICTINE TO INVESTIGATE ANY STATEMENT CONTAINED IN THIS APPLICATION. I HEREBY RELEASE ANY PARTY FROM LIABILITY AS A
RESULT OF ANY INFORMATION PROVIDED TO BENEDICTINE. IT IS UNDERSTOOD THAT I ACCEPT REGISTRATION AS A STUDENT AT BENEDICTINE
SUBJECT TO THE ABOVE PROVISIONS.
I UNDERSTAND THAT COMMUNICATIONS, INCLUDING UNIVERSITY FINANCIAL/STUDENT LOAN INFORMATION AND OTHER NOTIFICATIONS WILL BE SENT
VIA MY BENU EMAIL ACCOUNT. I ACCEPT RESPONSIBILITY TO MAINTAIN SAID ACCOUNT. (IF YOU PREFER TO RECEIVE PAPER NOTIFICATION, PLEASE
SUBMIT A WRITTEN STATEMENT TO THE OFFICE OF FINANCIAL AID.)
I GIVE BENEDICTINE UNIVERSITY PERMISSION TO USE MY LIKENESS IN PHOTOGRAPHS AND/OR VIDEO IN ANY AND ALL OF ITS PUBLICATIONS,
INCLUDING WEBSITES AND PAGES, AND IN ANY AND ALL OTHER MEDIA, WHETHER NOW KNOWN OR HEREAFTER EXISTING, CONTROLLED BY
BENEDICTINE UNIVERSITY, IN PERPETUITY, AND FOR OTHER USE BY THE UNIVERSITY INCLUDING BUT NOT LIMITED TO PROMOTING THE UNIVERSITY
AND ITS PROGRAMS AND ACTIVITIES. ALL PHOTOS TAKEN ARE WITHOUT COMPENSATION TO ME (THE UNDERSIGNED). ALL ELECTRONIC OR NONELECTRONIC NEGATIVES, POSITIVES AND PRINTS ARE OWNED BY THE UNIVERSITY.
I HEREBY ACKNOWLEDGE THAT I AM 18 YEARS OF AGE OR OLDER AND HAVE READ AND UNDERSTAND THE TERMS OF THIS APPLICATION AND RELEASE.
Signature of Applicant ______________________________________________________________ Date_________________________________
Signature of Parent or Guardian*______________________________________________________ Date_________________________________
*Required if applicant is 17 years of age or younger