Thank you for your interest in the undergraduate certificate program through the

College of Continuing Education at the University of Minnesota.

Please read the information contained in this application packet carefully to insure that you complete the application form accurately and have necessary materials sent to our office.

A complete listing of undergraduate certificates is on the following page.*

BEFORE YOU APPLY FOR ADMISSION

► www.cce.umn.edu

► Financial aid - http://www.cce.umn.edu/financialaid

HOW TO APPLY FOR ADMISSION Part I (materials that you complete and submit)~

NOTE: Application fee is not required for currently admitted UM degree or CCE credit certificate students.

Certificate Application Center Ruttan Hall Room 20 1994 Buford Ave. St. Paul, MN 55108

Part II (materials that you order to be sent on your behalf)

All transcripts should be sent to:Office of Admissions University of Minnesota - Twin Cities 240 Williamson Hall 231 Pillsbury Drive S.E. Minneapolis, MN 55455-0213

Note ~ We cannot process your application until all materials are received. Please arrange for official transcripts to reach the Office of Admissions on or before the deadline for the semester in which you wish to apply for admission.

Complete this application form (please type or print clearly)Attach a check or money order payable to the University of Minnesota for the $35 non-refundable application fee.

Send the completed application form and check or money order to:

Review admission criteria and general program information available on our Web site:

Other helpful Web sites:

Official college transcripts: Arrange to have an official transcript from all colleges or universities attended (even if no credit was earned) submitted to the address below directly from the institution (University of Minnesota transcripts do not need to be submitted by applicant). An official transcript is in a sealed envelope and has an official signature or seal, or is on security paper. Transcripts not sent in ths way are unacceptable and must be resent. Each transcript must have been issued within the last year. Official high school transcripts (if needed): If you have earned fewer than 26 semester (or 39 quarter) college credits that are transferable to the University of Minnesota, you must arrange to have an official high school transcript submitted to the address below directly from the institution. If you have not graduated from high school, but have taken the GED (high school equivalency), submit your GED test scores. If you attended or graduated from a secondary school in another country, please submit official transcripts and any test results required to enter a university in that country.

CREDIT CERTIFICATE PROGRAMS Application for Undergraduate Certificate Admission

Click on certificate of choice and then "costs."► Information on tuition and fee rates - http://www.cce.umn.edu/programs-and-courses/certificates/index.html

► Class schedule and online registration - http://onestop.umn.edu/onestop/registration.html

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Application Term (check one) Deadline

July 15

November 15

April 15

SELECT THE CERTIFICATE(S) FOR WHICH YOU WISH TO APPLY: Please check the box next to each certificate program to which you are applying for admission. If you wish to apply to a post-baccalaureate or graduate level certificate program, you should NOT complete this application form. Rather, you will need to complete an application form specific to that program (see www.cce.umn.edu)

International Students: Due to Federal restrictions on student visas, certificate programs are not open for admission to international students, unless students are currently admitted into a degree program.

Have you previously applied to a College of Continuing Education (CCE) certificate program?

PERSONAL INFORMATION (Please print clearly or type) University ID or Social Security Number Date of Birth Name (last, first, middle, former)

Home address (Street, City, State, Zip) Employer Name & Address (Street, City, State, Zip)

Daytime Phone (with area code) Evening Phone (with area code) Email Address

Phone Type: Home Business Cell

Phone Type: Home Business

Cell

Email Type: Home Business

Other (specify)

Graduated High School. Date:

Passed GED. Date:

Other: No high school diploma, no GED, and no other high school equivalency.

Names(s) of Universities/Colleges attended (all non-U of M transcripts need to be sent to the Office of Admissions)

Dates attended Degree awarded Transcripts (in sealed envelope or being sent from institution)

1. Yes Date:

2. Yes Date:

Fall Semester,

Spring Semester,

Summer Term,

Year:

Year:

Year:

Yes No

Have you ever been convicted of a felony or misdemeanor other than a minor traffic violation, or is any such charge now pending against you? *If yes, please attach a detailed statement of explanation. If your answer changes prior to enrollment, you must promptly contact the College of Continuing Education.

No Yes*

CREDIT CERTIFICATE PROGRAMS Application for Undergraduate Certificate Admission

Accounting Addiction Studies -Service Provider Track Addiction Studies -Self Designed Track Applied Business Construction Management Dakota Iapi Unspewicakiyapi

Facility Management Health Services Management Information Technology Infrastructure Interpreting Manufacturing Operations Management Nanotechnology Practice Ojibwemodaa Eta! Certificate

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COLLEGE OF CONTINUING EDUCATION CERTIFICATE APPLICATION QUESTIONS

Before you answer these questions, you are advised to be familiar with the certificate admission requirements. Please review the certificate information on our website at http://www.cce.umn.edu/certificates/ or contact us for grade point average and other admission criteria. If you plan to use this certificate toward a specific degree program, you are encouraged to consult with an adviser in your desired program prior to completing this application.

Certificate admissions are based on a student's previous academic record and educational objectives. Your transcripts provide us with grade point averages and patterns of completing coursework. The questions below are designed to give us a better understanding of your educational and vocational goals. The information will also be used by the admissions committee for those applications requiring a special review.

1. Have you ever applied for admission to a degree program at the University of Minnesota, Twin Cities campus; e.g., College of Liberal Arts, College of Science and Engineering, Carlson School of Management? If so, please list the college(s) to which you applied, and explain your current status; e.g., admitted, not admitted, missed deadline, working on a contract toward admission, already graduated, etc.

2. Please describe how this certificate program fits into your educational and/or career goals.

3. With whom have you consulted regarding your overall educational/career plans? (e.g. College of Liberal Arts, U of M Admissions Office, your employer's Human Resource department, Graduate School, CCE adviser, etc.)

4. If your overall grade point average is below the minimum recommended for admission, please describe what circumstances affected your previous performance and what has changed to ensure a high probability of success in a CCE Certificate program. This information will be used in a special review of the CCE Admissions Committee.

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REQUEST FOR CONFIDENTIAL INFORMATION The information requested below is voluntary and will be used for summary reports required for federal and state laws and regulations and to support institutional affirmative action efforts. It will not be used as a basis for admission or in a discriminatory manner. You will not be subjected to adverse treatment if you do not provide any of the requested information.

Gender (check one): Male Female

Ethnic background (check one): African-American (non-Hispanic origin): a person having origins in any of the black racial groups of Africa (excluding persons of Spanish, Portuguese, Latin American, or other Hispanic origin).

American Indian or Alaskan native: a person having origins in any of the original peoples of North America who maintains cultural identification through tribal affiliation or community recognition.

Asian or Pacific Islander: a person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. This includes, for example, China, Japan, Korea, India, the Philippine Islands, and Samoa.

Chicano or Mexican-American: a person of Mexican-American origin.

Hispanic: a person of Puerto Rican, Cuban, Central or South American, or other Spanish or Portuguese culture or origin, regardless of race.

White, non-Hispanic: a person having origins in any of the original peoples of Europe, North Africa, or the Middle East (excluding persons of Spanish or Portuguese origin).

Multi-ethnic background (please list): 1) 2)

I certify that the information I have provided on this application form is complete, accurate, and true to the best of my knowledge. I understand that it is my responsibility to submit transcripts from each academic institution (except the University of Minnesota) I have attended and the $35 application fee (if required). I understand that misrepresentation of application information is sufficient grounds for canceling admission.

Signature: Date:

This publication is available in alternative formats; contact the CCE Information Center, (612) 624-4000. The University of Minnesota is committed to the policy that all persons shall have equal access to its programs, facilities, and employment without regard to race, color, creed, religion, national origin, sex, age, marital status, disability, public assistance status, veteran status, or sexual orientation.

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PLEASE RETURN APPLICATION AND FEE TO:

College of Continuing Education Certificate Application Center 20 Ruttan Hall 1994 Buford Ave St. Paul, MN 55108

Telephone: (612) 624-4000 FAX: (612) 625-2402 E-Mail: cceinfo@umn.edu Website: http://www.cce.umn.edu/

CREDIT CERTIFICATE PROGRAMS - Application for Undergraduate Certificate Admission