Practical Writing：Application
for Admission <<BACK
APPLICANT
Legal Name
Wang Yi
Last/Family/Sur (Enter name exactly as it appears on official documents.) First/Given Middle (complete) Jr., etc.
Preferred name, if not first name (only one)
Former last name(s)
Birth Date 01/21/1965 US Social Security Number, if any
mm/dd/yyyy Required for US Citizens and Permanent Residents applying for financial aid
Preferred Telephone
Home
Cell (
13924783345
)
Area / Country / City Code E-mail Address wangyi@yahoo.com.cn IM Address Permanent home address Flat 408, Building No. 5 Wushan, Guangzhou Guangdaong People’s Republic
of China 510640
Number & Street Apartment #
City/Town County or Parish State/Province Country ZIP/Postal Code If different from above, please give your current mailing address for all admission correspondence.
(from
to
) Current mailing address
(mm / dd / yyyy) (mm / dd / yyyy)
Number & Street Apartment #
City / Town County or Parish State / Province Country ZIP / Postal Code
FUTURE PLANS
Your answers to these questions will vary for different colleges. If the online system did not ask you
to answer some of the questions you see in this section, this college chose not to ask that question of
its applicants.
College
Deadline
Entry Term:
Fall (Jul-Dec)
Spring (Jan-Jun)
Decision Plan
Academic Interests
Career Interest
Do you intend to apply for need-based financial aid?
Yes
No
Do you intend to apply for merit-based scholarships?
Yes
No
Do you intend to be a full-time student?
Yes
No
Do you intend to enroll in a degree program?
Yes
No
Do you intend to live in college housing?
Yes
No
What is the highest degree you intend to earn?
PhD
SIGNATURE
Application Fee / Payment If this college requires an application fee, how will you be paying it?
Online Payment
Will Mail Payment
Online Fee Waiver Request
Will Mail Fee Waiver Request
Required Signature
I certify that all information submitted in the admission process — including the application, the personal essay, any supplements, and any other supporting materials — is my own work, factually true, and honestly presented, and that these documents will become the property of the institutions to which I am applying and will not be returned to me. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, or revocation of course credit, grades, and degree, should the information I have certified be false.
I acknowledge that I have reviewed the application instructions for each college receiving this application. I understand that all offers of admission are conditional, pending receipt of final transcripts showing work comparable in quality to that upon which the offer was based, as well as honorable dismissal from the school.
I affirm that I will send an enrollment deposit (or equivalent) to only one institution; sending multiple deposits (or equivalent) may result in the withdrawal of my admission offers from all institutions. [Note: students may send an enrollment deposit (or equivalent) to a second institution where they have been admitted from the waitlist, provided that they inform the first institution that they will no longer be enrolling.] Signature Wang Yi Date 02/15/2012
mm / dd / yyyy
Common Application member institution admission offices do not discriminate on the basis of race, color, ethnicity, national origin, religion, creed, sex, age, marital status, parental status, physical disability, learning disability, political affiliation, veteran status, or sexual orientation.
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