DOMESTIC APPLICATION FOR ADMISSION TO DOCTORAL PROGRAM
For Currently Enrolled Master's Students
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. Name
Last First Middle
2. Student ID Number
3. Degree sought: PhD EdD
4. Distance Education: Yes
No
5. Department/Interdepartmental Program
6.
Permanent address (where mail will always reach you)
Mailing address for reply (if different from permanent)
Street
Street
City County State ZIP Code
City County State ZIP Code
By my signature below I affirm that I understand that submitting any false information to the University, including but not 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.
Applicant's Signature
Date
Departmental Recommendation to Graduate School
Effective Semester: Fall
Spring
Summer
Year ________ Degree: PhD
EdD
Department Head or Program Director Date
Advisor assigned to student
Department or Interdepartmental Program Date
Graduate School Approval
____________________________________________________________
Graduate
FOR GRADUATE SCHOOL USE ONLY. PLEASE DO NOT WRITE IN THE BOX BELOW.
SS#
Citizenship
DOE
Class
Adm Status
DOB
Sex
M F
Rac/Eth
Vet
County
R NR
Curriculum
Subcurriculum
Degree code
