Non-Degree Application

Are you a teacher in Adelphi University's High School Program?

Yes

No

Are you a teaching assistant in the Mineola School District?

Yes

No

Are you a teacher participating in the Levittown School District Partnership Program?

Yes

No

Were you directed to submit this application by the Office of Special Events?

Yes

No

Personal Data

First Name

Middle Name

Last Name

Other last name used on previous transcripts

Preferred Name

Birthdate

Social Security Number

Sex Assigned at Birth:

Female

Male

If you would like the opportunity, we invite you to share more about your gender identity.

Contact Information

Primary Phone Number

Cell Phone Number

Personal Email Address (please use a non-school email you'll keep long-term, like Gmail or Yahoo)

Mailing Address

Country

Street

City

Region

Postal Code

Citizenship

Were you born in the United States?

Yes

No

What is you country of birth?

Primary Citizenship:

Are you a permanent resident of the United States?

Do you currently hold a valid U.S. Visa?

Current United States visa:

Which visa do you plan to apply for?

Specify other intended visa type:

Ethnicity

If you wish to be identified with a particular ethnic group, please select the choice that most accurately describes your heritage. No information you provide will be used in a discriminatory manner.

Do you consider yourself to be Hispanic or Latin?

Yes

No

If you wish to identify yourself with a particular racial group, please check all that apply

Disciplinary History

Have you ever been convicted of, or pled guilty or no contest to, a felony or misdemeanor charge? (An affirmative response will not automatically prevent admission, but any omission or falsification is grounds for denial or rescission of admission or for expulsion)

Yes

No

Please explain.

Have you ever been suspended, dismissed, expelled or required to withdraw from any high school or college for academic or disciplinary reasons? (An affirmative response will not automatically prevent admission, but any omission or falsification is grounds for denial or rescission of admission or expulsion.)

Yes

No

Please explain.

Intended Program of Study

If you're interested in taking non-degree courses at Adelphi this summer (May-August), please visit the Summer Classes & Programs at Adelphi page for more information.

I will be taking classes during:

My non-degree enrollment status:

Graduate Non-Degree

Undergraduate Non-Degree

Visiting Non-Degree

Special Circumstance Non-Degree

My special circumstance is:

High School Graduate without a Bachelor's Degree

Personal Enrichment Courses (Degree Required)

I will be taking:

Graduate classes

Undergraduate classes

You must receive approval from the department in which you'd like to take graduate level courses as a non-degree student.
Please check off the box below acknowledging this.
Please see https://getting-started.adelphi.edu/new-students/graduate/grad-contacts/ for a list of departmental contacts.

I acknowledge that I am responsible for receiving approval for my courses from the department.

How many credits would you like to take?

Are you planning to take these as prerequisite classes you need before applying to a specific program?

Yes

No

Which program (either at Adelphi or another institution) are you looking to complete pre-requisite classes for?

Communications Sciences and Disorders

Nursing

Other

In what school are the undergraduate courses that you'd like to take?
Please see our bulletin at http://catalog.adelphi.edu/ for information.

Please note: If applying as a nursing non-degree student, your transcripts will be reviewed by an admissions counselor to assess your eligibility for our program.

Please list the courses you plan to take:
Please note: There is no guarantee that these courses will be available for your entry term of choice.

Please indicate your preferred campus/center:
Please note: There is no guarantee that these courses will be available at the location selected.

Previous Education

From which school did you earn your high school diploma?
If you earned a high school equivalency, please enter GED/General Equivalency

From which school did you earn your Bachelor's degree?
If you are a visiting non-degree student, please enter your current institution.

If you would like, you can upload an unofficial transcript/proof of degree here:

Additional Information

Have you previously applied to Adelphi?

Yes

No

Have you earned a degree from Adelphi?

Yes

No

List date of graduation:

Are you currently employed by Adelphi University?

Yes

No

Please list department, title and phone extension:

Is a relative(s) of yours an alumnus/a of Adelphi University?

Yes

No

Alumnus/a Name (include maiden, if applicable):

Alumnus/a Relationship to you:

Alumnus/a Date of Graduation:

Have you ever served in the US armed forces?

Yes

No

Statement of Intent

Please use the space provided to explain why you would like to attend Adelphi University as a non-degree student with the enrollment status you previously indicated.

Signature

I acknowledge that admission as a non-degree student does not guarantee admission to Adelphi University as a matriculated student, even if I perform well in the approved non-degree course(s).

Yes

I acknowledge that as a non-degree student I do not qualify for any financial aid, including scholarships, and that I am responsible for the full out-of-pocket cost of the non degree course(s).

Yes

I certify that the information provided in this application is complete and correct to the best of my knowledge. I understand that permission to register for these courses does not constitute admission to Adelphi University as a candidate for a degree. To be accepted as a degree candidate I must file a formal application for degree status and meet normal degree program admission standards.

Signature

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Please enter today's date.

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