Professional Credit Application

Applicants who are non-degree seeking will not qualify for government financial aid. Please consider your options carefully when applying.

Biographical Information

First Name

Middle Name

Last Name

Suffix

Other Last Names Used

*If you've used another last name during undergraduate or graduate enrollment please list it below.

Sex

*This field is used for state-required reporting and will not be used to determine admissibility.

Birthdate

Contact Information

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Cell Phone Number

*If you do not have a cell phone, please enter a number in which we can reach you. If you do not have any form of phone, please enter 000-000-0000.

Student Alternate Phone

May we text you?

*By selecting Yes, I agree to receive sms messages from Kutztown University to the mobile number I have provided. Kutztown may text you periodic updates about your application. You can unsubscribe at any time. Msg & Data rates may apply.

Yes

Residency

Primary Citizenship

Dual Citizenship

Social Security Number

Colleges and universities are asked by many groups, including the federal government, accrediting associations, college guides, and newspapers, to describe the ethnic/racial backgrounds of their students and employees. In order to respond to these requests, we ask you to answer the following two questions.

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

Black or African American: A person having origins in any of the black racial groups of Africa.

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

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

American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), who maintains cultural identification though tribal affiliation or community attachment.

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

Are you Hispanic or Latino?

Yes

No

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Academic Interest

Are you seeking an Endorsement?

Yes

No

Endorsements

Please list which school district you are associated with

Are you seeking to take a few courses as a Professional Credit student?

Yes

No

Course Information

*Please provide the course number and title of the course(s) you wish to take.

Start Term

Academic history

Applicants are asked to list all colleges and universities attended, including Kutztown University. All official transcript requests should be made by the applicant to their host institution(s) and sent directly to: Kutztown University, Office of Graduate Admissions, P.O. Box 730, Kutztown, PA 19530 or through graduate@kutztown.edu. *For current or previous KU students, you must include KU in the institution list below. You do not need to request a transcript; it will be obtained for you.

School Name

School Address

Country

Street

City

Region

Postal Code

CEEB Code

Graduation Date / Expected Graduation Date

Have you earned a degree from this institution?

Signature

I certify that I have read this application in its entirety and the information hereon is complete, accurate, and true to the best of my knowledge. I understand that my misrepresentation of facts hereon will cause for refusal of admission, cancellation of admission, or expulsion from the University if discovered subsequently. I agree that as a student I am bound by the Kutztown University Graduate Catalog.

Kutztown University of Pennsylvania does not ask for criminal history information on its application for admission.

Please note, however, that some criminal and non-criminal conduct may render you ineligible for professional licensure, and/or prohibit you from becoming employed in certain professional fields. If you have any questions, you should contact the admissions office, graduate@kutztown.edu and/or phone 610-683-4200.

Additionally, non-degree applicants are not eligible for federal financial aid and are required to assume all fiscal responsibilities associated with their course(s) and fees.

By confirming your submission, you agree to the above statement for your entire online application.

In place of your signature, please type your full legal name:

Full Legal Name

Professional Credit Application - Non-Degree