INTERNATIONAL APPLICATION FOR ADMISSION TO DOCTORAL PROGRAM FOR CURRENTLY ENROLLED KSU MASTERS STUDENTS (Spring 2011 and

Beyond)
This form may be used by students currently completing a master's degree at Kansas State who are applying for a doctoral degree in the same curriculum. All materials submitted in conjunction with an application become the property of the University and will not be returned. Materials submitted with the original application to the master's program will be retained in the doctoral file. PLEASE TYPE OR PRINT CLEARLY.
1. LIST NAME AS SHOWN ON PASSPORT LAST: 2. WID Number 3. FIRST: Degree sought: PhD EdD 4. MIDDLE: Current Visa Type

5. 7.

Department or Interdepartmental Program Permanent International address (cannot be a U.S. address):

6.

DISTANCE EDUCATION

Yes

No

Local mailing address for reply:

Street

Street

Street

Street

City

State/Province

Postal Code

City

State/Province

Postal Code

Country Phone Email

Country Phone Fax Number

I affirm that I understand that submitting any false information to the University, including but no limited to, false transcripts, test scores or any information contained on this form, or withholding information about my previous academic history will make my application for admission to Kansas State University, as well as any future applications, subject to denial, or may result in dismissal from the University. Applicants Signature __________________________________________________________________ Date ___________________________

APPLICANT MUST FILL OUT THE AFFIDAVIT OF FINANCIAL SUPPORT FORM at https://www.ksu.edu/grad/application/forms/gsa7-1-new.doc
DEPARTMENTAL RECOMMENDATION TO GRADUATE SCHOOL
SEMESTER: Fall Spring Summer Year ___________ DEGREE: EdD PhD

DISTANCE EDUCATION
YES NO

ADVISOR ASSIGNED TO STUDENT: _____________________________________________________________________

Source of support
1. Assistantship from K-State: GTA ______ (tenths) Date assistantship to begin: _________________ GRA ______ (tenths) at $_______________ PER YEAR (do not list biweekly rate)

2. Other ________________________________________________

Evidence of support other than that provided by a K-State department must be documented.

If the applicant is not on an appointment $28,176, or if the stipend is less than $18,919 for a GRA or $12,655 for a GTA, the source of funding is: applicants personal funds; sponsoring individual; sponsoring organization. The affidavit of financial support has been completed and attached. (PLEASE NOTE THAT THE APPLICANT MUST SIGN IN SECTION 1 OF THE AFFIDAVIT EVEN IF AN ASSISTANTSHIP OR GOVERNMENT SUPPORT IS AWARDED.) An additional $7,000 is required for each year for each of the first two dependents; $3,300 for each additional dependent that accompanies you. This amount should be added to $28,176, for the total amount required per year. The total amount provided must equal the total amount required. Tuition is based on 9 hours.

________________________________________________________________ Department Head or Program Director Date

________________________________________________________ Department or interdepartmental program Date

FOR GRADUATE SCHOOL USE ONLY. PLEASE DO NOT WRITE IN THE BOX BELOW.
SEVIS# Curriculum Citizenship DOE Subcurriculum Class Adm Status

For the Graduate School

Date