Graduate Admissions


Hayworth College Graduate Programs
Queens University of Charlotte

Application for Graduate Admission


PLEASE INDICATE THE PROGRAM AND STATUS FOR WHICH YOU ARE APPLYING.

                   Program:

If you selected "Post Baccalaureate Teaching Certification,"
choose a certification area:         *All others should choose "Not Applicable"

Have you been admitted to Queens University of Charlotte in the past?   Yes   No

PERSONAL INFORMATION

Last Name:    First Name:    Middle Name:

Date of Birth:       Male   Female

Home Address
          Street:
              City:    County:
            State:    Zip Code:    
Home Phone:    E-mail Address:

Employer:      Position:
Street Address:
                  City:     
                State:      Zip Code:      Work Telephone: Ext.
Will your company assist you with tuition?   Yes   No

Religious preference: (voluntary)  


Country of Citizenship:      Social Security Number: --
International Students - enter your Resident Alien Number or Visa Type:

The following information is requested so that Queens university of Charlotte may demonstrate to the US Department of Education its compliance with Title VI of the 1964 Civil Rights Act.  Your response is voluntary.
Please check the proper category:

Marital Status:Single   Married

TESTING AND LICENSURE INFORMATION

ENTRANCE EXAMS

Have you taken the GRE?Yes No  
If so, Date:      Score: Verbal    Analytical    Quantitative

Candidates from non-English speaking countries must also submit satisfactory scores for
the Test of English as a Foreign Language (TOEFL).  Date of TOEFL   Score

TEACHER LICENSURE INFORMATION

Name as it appears on license:
Issued by which state:   Date:
       License Number:   Class: A G 6 yrs  Date of Expiration:

NURSING LICENSURE INFORMATION

Name as it appears on license:
Issued by which state:   Date:
       License Number:   Date of Expiration:

 

ACADEMIC BACKGROUND

List ALL colleges and/or universities attended.  The Southern Association of Colleges & Schools requires Queens to collect this information.  Failure to provide complete information is a violation of the honor code and may result in a decline of application to Queens.
Institution Location Dates of Enrollment Degree/Major
 


*A resume may be submitted in lieu of the following information.  See below.

PROFESSIONAL BACKGROUND:
List employment history, full and part-time, most recent first.  Include dates (from-to), the firm/organization's name, and job title/description.


 

RECOGNITION:
List civic, professional, and personal honors and awards received.


 

CAREER DEVELOPMENT:
List professional affiliations and achievements.


 

RESUME:
You may use the space below to paste the text of your resume in lieu of completing the three fields above.

 

THE QUEENS UNIVERSITY OF CHARLOTTE HONOR CODE

The honor code regulates all phases of life at Queens University of Charlotte and is binding on all members of the community.  It involves three fundamental principles: truthfulness at all times; respect for the property of others; and honesty in test, examinations, term papers and all other academic assignments.

By clicking the "submit" button below, I acknowledge that I have read this statement
thoroughly, that this application is true, and that I pledge to uphold the Honor Code as long
as I am a member of the Queens Community.

 

 
   

Queens University of Charlotte  1900 Selwyn Avenue  Charlotte, NC  28274  (704) 337-2314
Modified by Hayworth Webmaster