MBA Application for Admission

Sunday, May. 19, 2013

MBA Application for Admission
Instructions Please fill in all information completely and accurately. The application form must be completed within one computer session since it cannot be saved prior to submission. You may wish to print a copy of the completed form prior to submission. For additional information about the admission requirements and required application materials, visit the MBA web site at www.eiu.edu/~mba or contact the MBA office at mba@eiu.edu.

Applicant Information
First Name	Middle Name	Last Name

All Previous Names

Birth Date

Permanent Address
Address 1
Address 2
City
State or Province
Country
Zip or Postal Code

Local Address ( Same as Permanent Address)
Address 1
Address 2
City	State Zip

Email Address

Home Phone	Work Phone	Local Phone

Illinois Resident
	Yes
	No

If yes, then how long? (years, months)

Citizenship
	U.S.
	non U.S.

If non U.S.,
Specify Country	Alien Registration Number	Type of Visa

Plans for Program Completion

I plan to begin the program
Semester	Year

I plan to attend my classes:
	On-Campus
	Off-campus at Parkland in Champaign

I plan to complete the program as a:
	Full-time Student
	Part-time Student

I plan to enroll in this program option:
MBA with Applied Management Option
MBA with Research Option
MBA with Accountancy Concentration
Graduate Certificate in Accountancy

All Colleges or Universities Attended Including Eastern
School 1
Name of School	City	State or Country
Dates Attended	Degree or Hours Earned	Major
School 2
Name of School	City	State or Country
Dates Atended	Degree or Hours Earned	Major
School 3
Name of School	City	State or Country
Dates Attended	Degree or Hours Earned	Major

Your responses to these questions will not affect admission decisions and are optional. This information is requested so that we may demonstrate to federal and state agencies that the institution is in compliance with appropriate regulations.
Gender
	Male
	Female

Ethnic Origin
	White (Non-Hispanic)
	Black (Non-Hispanic)
	Asian or Pacific Islander
	Hispanic
	American Indian or Alaskan Native
	Other

Additional Requirements:

Send as attached documents to mba@eiu.edu or mail to Graduate Business Studies, Eastern Illinois University, 600 Lincoln Ave., Charleston, IL 61920:

A current resume clearly describing your employment experience. Identify for each position the employer, time period, your titles, and your responsibilities.
A one-page typed statement explaining your career and academic goals and how you have and will continue to prepare yourself to meet those goals.
A completed and signed Honor Code Agreement.

You must also submit two completed reference forms, sent directly to the MBA office by the person completing them, (preferably, at least one reference should be from a previous or current employer).

I understand that withholding information requested on this application may make me ineligible for admission to the university or subject to dismissal. I certify that the information provided on the application is correct and complete.

Eastern Illinois University is an equal opportunity institution. The University adheres to section 504 of the Rehabilitation Act.

If you are interested in applying for a Graduate Assistantship in the School of Business, go to: http://www.eiu.edu/~mba/gradassist-index.php

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