PREVIOUS EDUCATION: List all high schools and colleges attended.
Name of Institution Location
Applicants are required to supply an unofficial copy of their high school transcript or equivalency or a copy of their most recent
I CERTIFY THAT ALL INFORMATION PROVIDED IN THE APPLICATION AND ACCOMPANYING DOCUMENTS
ARE CORRECT TO THE BEST OF MY KNOWLEDGE.
Signature: Date: _____________________________________
Mail Application, $25.00 application fee and unofficial copy of transcripts to:
Schenectady, NY 12308
THIS IS A TWO PART QUESTION; PLEASE ANSWER QUESTIONS IN BOTH SECTIONS, A. and B.
A. Ethnicity: Are you Hispanic/Latino? Yes No
Hispanic: A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin; regardless of race.
B. Race: Please select one or more of the following racial categories to describe yourself:
WHITE: A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
AMERICAN INDIAN OR ALASKAN NATIVE: A person having origins in any of the original peoples of North and South
America (including Central America) who maintains cultural identification through tribal affiliation or community attachment.
BLACK or AFRICAN AMERICAN: A person having origins in any of the black racial groups of Africa.
ASIAN: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent,
including, for example: Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
NATIVE HAWAIIAN or OTHER PACIFIC ISLANDER: A person having origins in any of the original peoples of Hawaii,
Guam, Somoa, or other Pacific Islands.
NON RESIDENT ALIEN: A person who is not a citizen or national of the United States and who is in this country on a visa or
FOR OFFICE USE ONLY:
Application Fee Paid _________________________________ Application Fee Waived ____________________________________
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