Stockton University ● 101 Vera King Farris Drive ● Galloway, NJ 08205-9441 ● gradschool@stockton.edu
Master of Science in Communication Disorders: Hispanic Emphasis Specialization
Supplemental Questions
Prospective students interested in the Master of Science in Communication Disorders-Hispanic Emphasis
Specialization program at Stockton University must complete this supplemental questionnaire. This form must
be uploaded to the CSDCAS application which must be verified by or prior to the February 1
st
deadline. For
details about this program or the admissions process, please visit www.stockton.edu/grad.
Applicant Name: ______________________________________________________ CAS ID #:__________________
Personal E-mail: __________________________________________ Phone: ________________________________
P
lease respond to the following questions:
1. Which dialect(s) of Spanish do you speak?___________________________________________________________
2. How did you learn/acquire Spanish?________________________________________________________________
3. D
etermine your level of Spanish Fluency by determining your level of proficiency in the following categories.
4. Have you completed the pre-requisite course in Second Language Acquisition? ______ Yes ______ No
If Yes
:
Pr
ovide the name of the institution where course was taken:_____________________________________________
Course Title: ____________________________________Grade Achieved in Course (no less than “B+”):___
_____
If
No:
When will you be taking the course? _______________________________________________________________
Name of Institution where you will be taking the course: _______________________________________________
5. I
f accepted into the MSCD program, will you be applying for a MSCD-HES Graduate Assistantship
?
______ Yes ______ No
Required Signature
Please provide your signature below to affirm that you have read over the MSCD-HES information and admissions
criteria on the MSCD Website.
I have read the MSCD-HES information and admissions criteria on the MSCD Website including:
• The MSCD course requirements with the MSCD-HES assignments infused throughout the curriculum
• The required elective: CMDS 6450: Bilingual/Multicultural Populations-Evaluation and Treatment
• The required Experiences: CMDS 5904: Bilingual Specialty Clinic and CMDS 5902: Practicum II and/or CMDS 5903:
Practicum III
• The required community engagement activities in the Hispanic Community
_________
_____________________________________________________ ___________________________
Applicant Signature Date
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signature
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