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Union College

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Graduate Psychology Study - Application for Admission
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I. Personal Information
*Fields appearing in RED are required.
 
1. Title Ms. Mrs. Mr.
 
First Name:
Middle Initial:
Last Name:
Maiden Name:
Prefer to be called:
Former Last Name(s):

2. Social Security Number: 

3.
Mailing Address:
City:
State:
County: 
Zip     
 
6. Telephone Home:     Telephone Work  

7. E-mail Address: 

8. Date of Birth (mm/dd/yr): 
 
9. Gender:
 
10. Race:
   
11. Religious Preference:
  Church Member? Yes No
 
12. Marital Status:     Spouse's Name:  
Union Graduate? 
 
13. Are you a U.S. Citizen?  Yes  No
  If not, where are you a citizen?
  Are you a resident alien?  Yes  No
 
Part II. Application Information
   
19. Program: 
   
20. Campus: 
   
21.

Term Entering:      Year:

  Emphasis: 
   
Part III. Educational Background
 
22. Do you have transfer work:  Yes  No
  Institution:
   
23. Do you have teaching certification: Yes  No
 
24. College/University 1
  Name:   
  Institution's Location:    State: 
  Enrollment Date (mm/dd/yy):  From    to 
  Degree:   Major:
 
25. College/University 2
  Name:   
  Institution's Location:    State:
  Enrollment Date (mm/dd/yy):  From    to 
  Degree:   Major:
   
Part IV. Other Information
   
26. How did you hear about Union College? (check all that apply)
 
Web - Google or Facebook Theatre Ad
Email Ad Newspaper Ad
Friend Representative Visited Area
Radio Ad Other
   

To complete the application you must request two official transcripts be sent to the Union College Department of Graduate Studies from the listed institutions. Have you requested these?

Yes     No


Union College does not discriminate on the basis of race, religion, creed, national or ethnic origin, age, sex, marital status, or disability in administration of its educational policies, admission policies, scholarship and loan programs, athletic and other school administered programs.

When you submit and verify this application, you will be directed to a method of payment page. The choices there will be credit card or check.  Please have the appropriate information ready.
***The application process is not complete until the Graduate Studies Office has received a $25 nonrefundable application fee and official transcripts of your transfer work. 


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310 College St. - Barbourville, KY - 40906
1-800-489-8646