Montana State University Billings
COMT 587 Application
Complete this application in its entirety. Incomplete applications cannot be accepted.
First Name: Middle Initial: Last Name:
Date of Birth: ________________________________
Do you have a previous last name? yes no
If you answered yes, what is it?
Cell Number: Email Address:
Address:
City: State: Zip:
Have you ever been a student at MSUB? yes no
SSN# or MSUB Student ID# ____________________________________________
Education Level: Participants must have a Bachelor’s degree or higher.
Do you currently have a Bachelor’s Degree? yes no
If yes, what major?
Do you currently have a Master’s Degree? yes no
If yes, what major?
Do you currently have a Ph.D.? yes no
If yes, what major?
Are you currently teaching? yes no
If yes, what grade and where?
Before emailing your application:
1. Did you include transcripts with this application? yes no
2. Did you include your one-page paper (double spaced) telling us why you’d like to take this course?
_____yes ___
no
(If you do not have an educational background in the humanities, please also note in your statement any
relevant experience you wished to have considered.)
3. Do you intend to stay on-campus in the residence halls during the face-to-face courses? yes no
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4. Do you intend to eat some or all meals on-campus during the face-to-face courses? yes no
If you answered yes to numbers 3 and/or 4 above, we will send you more information.
Early Application Deadline: April 1, 2018. Early submission is strongly encouraged; applicants will be
accepted on a “rolling basis”.
Final Application Deadline: June 4, 2018.
Send all application information to: Dr. Sam Boerboom
MSU Billings
1500 University Drive, LA
610 Billings, MT 59101
Or Email:
samuel.boerboom@msubilli
ngs.edu
406.657-2962
Maximum number of students selected: 18
Questions? Email or call: Kevin Nemeth 406.896.5871 or
ecinfo@msubillings.edu
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