Fillable APPLICATION FOR GRADUATE ADMISSION (Montana Tech)

Fill Online, Printable, Fillable, Blank APPLICATION FOR GRADUATE ADMISSION (Montana Tech) Form

Use Fill to complete blank online MONTANA TECH pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

APPLICATION FOR GRADUATE ADMISSION (Montana Tech)

On average this form takes 60 minutes to complete

The APPLICATION FOR GRADUATE ADMISSION (Montana Tech) form is 7 pages long and contains:

  • 1 signature
  • 36 check-boxes
  • 219 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Montana Tech

BROWSE MONTANA TECH FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
_____
______________________________________________________________________
_________________________________
_________________________________
_______________________________
________________________________
________________________________
_________________________
APPLICATION FOR GRADUATE ADMISSION
Please complete application electronically or by typing or printing clearly in pen, using black ink. All application materials
must be submitted to Graduate School Office; Montana Tech; 1300 West Park Street; Butte, MT 59701 USA.
EFFECTIVE TERM: Spring
______
Summer
______
Fall Year: ________
NAME AND CONTACT INFORMATION
Legal Name (Last, First):
Previous Names (if any):
______________________________________________________________________
Birthdate:
________________________________
___________________________________
Email:
Permanent Address:
Street:
Line 2:
_______________________
City, State, Zip:
Social Security Number:
_____________________________
(not required, but helps distinguish between applicants with similar names.)
Phone Number:
Mailing Address:
Street:
Line 2:
City, State, Zip
Country of Citizenship: Country of Birth:
_______________________ __________________________
DEGREE PROGRAM OF STUDY:
Please check the box to indicate program for application.
A – Thesis option; B – Non-thesis option; C – Certificate Program * GRE NOT Required
Master of Science Programs, On-Campus:
Electrical Engineering (A, B)
Environmental Engineering (A, B)
General Engineering with options (A, B)
Civil
Mechanical
Industrial Hygiene – On Campus (A, B)
Interdisciplinary Master’s Program (A, B)
Materials Science and Engineering (A, B)
Metallurgy/Mineral Processing (A, B)
Mining Engineering * (A, B)
Petroleum Engineering (A, B)
Geoscience with options (A, B)
Engineering Geology
Geochemistry
Geology
Geological Engineering
Geophysical Engineering
Hydrogeology
Hydrogeological Engineering
Restoration Ecology (A, B) *
Graduate Certificate Programs
Computational Science Graduate Certificate * (C)
Master of Science Programs, Online:
Industrial Hygiene – Professional Track * (B)
Project Engineering and Management * (B)
Master of Engineering, Online:
Master of Engineering with options (B)
Ph.D. Program, On Campus:
Montana State University collaboration
Healthcare Informatics Graduate Certificate, online (C)
Earth Sciences Engineering, Ph.D. (A)
Restoration Graduate Certificate * (C)
PRIORITY DEADLINES: US Applicants – For Fall semester (April 1*), Spring semester (Oct 1), Summer semester (Jan 1)
International Applicants – For Fall semester (March 1*), Spring semester (July 1), Summer semester (Dec 1)
Ph.D. applications must be complete by January 1 for Fall acceptance. Ph.D. programs only accept students in the Fall term.
All Petroleum Engineering and Geoscience MS applicants – Fall semester application deadline is March 1
st
REV. 8/2020
______
If not a US citizen, are you a US permanent resident?
Green Card #
___________________________________
☐
Yes
☐
No
If you are not a US citizen, but have permanent residency, you must provide a copy of the front and back of your green card.
If you are a US citizen or permanent resident, are you a Montana Resident?
☐
Yes
☐
No
You must complete the Residency Section on the last page of this application.
ACADEMIC HISTORY
Please list all colleges/universities attended. Official transcripts must be sent directly to Montana Tech Graduate School Office or
provided in an envelope sealed by the University’s Registrar’s office. Transcripts from foreign universities not in Canada, the UK,
New Zealand or Australia, must be evaluated course-by-course by a qualified service, such as www.ece.org or www.wes.org, and
sent directly to Montana Tech by that firm. These firms require official transcripts to be sent directly from the university. If more
space is needed, attach a separate page
College or University
Name
City/State/Country
Dates Attended
From To
Major(s)
GPA
Degree
Received
Have you previously attended Montana Tech?
☐
Yes
☐
No
Dates:
____
to
_________________
Institution:
_______________________
Did you attend college during the past year?
☐
Yes
☐
No
GRE - GRADUATE RECORD EXAMINATION
Some programs require GRE scores (see program section of application). Official scores for the General Test must be sent to
Montana Tech Graduate School Office (Montana Tech’s School Code is 4487). See www.ets.org/gre for testing sites and sample
questions.
GRE General Test Scores: Verbal:
_____
Quantitative:
______
Writing:
______
Test Date
__________________________
ENGLISH PROFICIENCY
Applicants who are not US citizens or have not attended university in the USA, Canada, New Zealand, Australia, or UK must take the
TOEFL or IELTS to demonstrate English proficiency. Montana Tech requires a TOEFL iBT score of 78 or above or an IELTS score of 6.5
or above. MPEM program requires a TOEFL score of 80 or IELTS score of 7.0. Ph.D. programs require a TOEFL iBT score of 90 or
above or an IELTS of 7.5 or above. You must have IELTS or TOEFL send your score directly to Montana Tech.
English Proficiency Score: Test type Test
☐
TOEFL
☐
IELTS
Date:
__________________________
REFERENCES
Please list the names, affiliations, email addresses, and positions of three persons (not relatives) you are asking for references. They
should be qualified to give information concerning your potential for success in graduate school, your academic and professional
ability, and your character. Examples are professors in your major field, technical supervisors, or department deans. Your references
may provide letters or use Montana Tech’s reference form. Reference Forms and/or letters should be returned to Graduate School,
Montana Tech, 1300 West Park St, Butte, MT 59701 (USA) or gradschool@mtech.edu
Reference Name Email address Affiliation Position
REV. 8/2020
________________________
_______________________________
REQUIRED SAFETY AND SECURITY QUESTIONS
Yes
No
Have you ever been convicted of a felony (please include instances of deferred
sentencing)?
Yes
No
Have you ever been subjected to court-ordered confinement for threatening or causing
physical or emotional injury to persons or property?
Yes
No
Have you ever been disciplined, suspended from, or placed on probation at any educational
institution for non-academic reasons? [If yes, attach explanation.]
Yes
No
Have you ever been required to register as a sexual or violent offender?
SIGNATURE AND CERTIFICATION (REQUIRED)
I hereby certify that to the best of my knowledge, the foregoing and following information provided by me is true and
complete without evasion or misrepresentation. I understand that if it is later found otherwise, it is sufficient cause for
rejection or dismissal. If my application is approved, I agree to abide by the present and future rules and regulations,
both academic and nonacademic, and the scholastic standards of Montana Tech, its colleges, schools, departments and
institutes, including but not limited to those rules, regulations and standards stated in both the undergraduate and
graduate catalogs. I further acknowledge that if I fail to adhere to these regulations or meet these requirements, my
registration may be canceled.
Date:
Applicant’s Complete Legal Signature
Montana Tech does not discriminate in admission, or the provision of services, nor employment policies on the basis of
race, gender, national origin or ancestry, marital status, creed, religion, color, political ideas, sexual preference, age, or
physical or mental disability.
If you have a disability that should be brought to the attention of Montana Tech, please submit a confidential request
for accommodation to the Graduate School Office, Enrollment Services Office, or Dean of Students. Documentation of
disability may be required. No qualified individual with a disability will be by reason of such disability excluded from
participation in or be denied benefits for the services, program, or activities of a public entity or be subject to
discrimination by such entity. Applicants who need an alternate version of this application may request it from either of
the above noted offices. All requests regarding disability will be confidential and will not be used as a factor in granting
or denying admission.
The Jeanne Clery Act, a consumer protection law, requires all colleges and universities who receive federal funding to
share information about crime on campus, efforts to improve campus safety, and inform the public of crime in or around
campus. Montana Tech's report can be found here: https://www.mtech.edu/campus-safety/security-reports.html
REV. 8/2020
click to sign
signature
click to edit
APPLICATION CHECK LIST
☐ Completed and signed application form, including residency, international & statistical information
☐ Official transcripts from all post-secondary institutions attended, sent DIRECTLY from that institution, or in an
envelope sealed by that institution
☐ For most institutions attended outside the USA, an official course-by-course evaluation of the transcript by WES
or ECE
☐ Your typed personal/professional statement outlining your academic and professional goals and how they relate
to your chosen field of study
☐ Three letters of reference, sent directly from each of the references. Alternatively, the reference may provide
the letter to you in a sealed envelope, with the reference’s signature over the seal
☐ Non-refundable application fee of $50, paid by check or money order, and accompanying this application.
☐ Additional program-specific materials, as required:
(see: http://www.mtech.edu/academics/gradschool/apply/apply-us-requirements.htm)
☐ TOEFL or IELTS scores of English proficiency, if required
☐ Graduate Record Examination (GRE) scores, if required by the program
☐ For green-card holders or other resident aliens, provide a copy of both sides of your residency card
☐ For international students, a Statement of Financial Support must be completed by you, your sponsor and bank
officials. http://www.mtech.edu/academics/gradschool/Forms/international_statement_financial_support.pdf
REV. 8/2020
SUPPLEMENTARY APPLICATION INFORMATION
FOR INTERNATIONAL GRADUATE STUDENTS
This section must be completed by applicants who are NOT US citizens or resident aliens.
1. Are you currently in the United States? ☐ Yes ☐ No
2. If YES, what is your immigration status (visa type)? ☐ F-1 ☐ F-2 ☐ J-1 ☐ J-2
3. If you have an active I-20, where is it held?
________________________
4. Have you completed or are you in the process of completing any undergraduate or graduate degree at a university
or college in the United States? ☐ Yes ☐ No
If YES, you do not need to provide TOEFL or IELTS scores to demonstrate English proficiency.
5. Please provide the names and relationships of dependents who are in the USA with you or would accompany you to
the United States.
Name
Relationship
Date of Birth
Country of
Citizenship
REV. 8/2020
_____________________ _____________________
_______________________________________________ ______________________
_____________________________________ ________________________________
_________________________________________________
RESIDENCY INFORMATION (for US Citizens and Permanent Residents Only)
1.
2.
3.
4.
5.
Are you claiming Montana residency for fee purposes? ☐ Yes ☐ No
If the answer to #1 is YES, please indicate whether or not the following statements describe you:
a) I am a member of the armed forces of the United States assigned to active duty in Montana.
☐ Yes ☐ No
b) I am the spouse of a member of the armed forces of the United States assigned to active duty in Montana.
☐ Yes ☐ No
c) I permanently reside in Montana and am employed full-time in a permanent job in Montana and the primary
purpose for my coming to Montana was not the education of myself, my spouse, or my dependent children.
☐ Yes ☐ No
d) I am the spouse of an individual who permanently resides in Montana and am employed full-time in a
permanent job in Montana and the primary purpose for my coming to Montana was not the education of
myself, my spouse, or my dependent children.
☐ Yes ☐ No
Please complete A–H below:
a)
______________________
Of what state are you a resident? Date residency began:
____________________
b) How long have you been a resident of that state? Years:
______
Months:
____________________
c) Did you file a state income tax return last year? ☐ Yes ☐ No In what state?
Tax residency status: ☐ Full-year resident? ☐ Part-year resident?
d) In what state are you registered to vote?
_____________________
Date registered:
______________________
e) What state issued your driver’s license?
_________________
Date issued:
______________________
f) In what state is your vehicle registered? Date registered:
g) Employment status: ☐ Full time ☐ Part time ☐ Retired ☐ Seasonal ☐ Unemployed
Employer: Start Date:
Address: City/State Zip:
Spouse’s employment status? ☐ Full time ☐ Part time ☐ Retired ☐ Seasonal ☐ Unemployed
Employer:
__________________________________________
Start Date:
_________________________________
Address:
_____________________________________
City/State Zip:
_____________________________________
Have you served in the armed services? ☐ Yes ☐ No Dates of Active Duty:
______
to
_______________
City and State from which you entered the service: ,
Please complete the table below with information about yourself for the past two years:
Dates (Mo/Yr)
From To
Place of Residence
Employment
Schools Attended
REV. 8/2020
STATISTICAL INFORMATION
This information will be separated from your application and used for statistical purposes.
☐ Male ☐ Female
Are you a US veteran? ☐ Yes ☐ No
Are you a US Citizen, Permanent Resident, or other category of Resident Alien? ☐ Yes ☐ No
If the answer to the previous question is yes, please designate your ethnicity and indicate your race(s):
Are you Hispanic or Latino? ☐ Yes ☐ No
Regardless of your answer to the previous question, please indicate one or more races from the list below:
☐ American Indian or Alaska Native
Please specify primary Tribal affiliation:
Please indicate reservation, if applicable:
☐ Asian
☐ Black or African American
☐ Native Hawaiian or Other Pacific Islander
☐ White
REV. 8/2020
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

APPLICATION FOR GRADUATE ADMISSION (Montana Tech)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 1 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document