Fillable Application For Graduate Nondegree Readmission Form (Page 2 of 2) in pdf

If you are not a U.S. citizen, are you a "Lawful Permanent Resident" of the U.S.? Yes____ No____ If yes, please provide a photocopy of your Alien Registration Receipt Card or

"Green Card"

Were you in the armed services? Yes____ No ____

If yes, dates and locale of active duty:

Have you ever lived in Montana? Yes ____ No ____

If yes, most recent uninterrupted period

(from)______________________ (to)_______________________

Of what state are you a resident?

If you claim Montana residency, complete the appropriate column information below

If your parents claim you as a federal tax exemption, answer the following:

If your parents do not claim you as a federal tax exemption, answer the following:

Father's Name __________________________________________________________

∙When did your residency in Montana begin? ________________________________

Mailing

Address ____________________________Area Code/Phone No._________________

∙Where and when did you last file state income tax returns? ___________________

Mother's Name __________________________________________________________

∙Have you been continuously present in Montana for the past 12 months? Yes____

Mailing

Address ___________________________Area Code/Phone No. __________________

No ____ explain____________________________________________________

∙When did your parent's (s') Montana residency begin? _______________________

∙Where and when did you last vote? _______________________________________

∙Where and when did they last file a state income tax return?___________________

∙From what state is your driver's license and date issued?_____________________

∙Where and when did they last vote? _______________________________________

∙In what state is your motor vehicle registered and the current license date?

∙What is their employment status

time, retired)?_________________

(full-time, part-

______________________________________________________________________

∙Occupation(s)? ________________________________________________________

∙If you are married, what is your spouse's employment status (full-time, part-time,

∙Employer(s)? __________________________________________________________

retired)? ______________________________________________________________

∙Date present employment began? ________________________________________

∙Spouse's employer and date employment began: ___________________________

If you were previously declared a non-resident and now believe you qualify for in-state status, you should also complete a Residency

Questionnaire packet (available from the Graduate School) and submit it (including documentation) along with this application.

***INTERNATIONAL APPLICANTS***

BE SURE TO COMPLETE ALL APPLICABLE SECTIONS

Name and relationship of each dependent coming to the United States with you:

Spouse's name, complete mailing address and phone number:

If you are now in the United States, indicate non-immigrant visa type and expiration date:

Language

Preparation

Financial

Information

Which evidence of English proficiency do you wish to present?________________

Funds available from savings

$ ______________________________

What language is spoken in your home? ___________________________________

Committed by family or friends

$ ______________________________

How many years of formal instruction in English have you completed? _________

Committed by your government

$ ______________________________

At what educational level was that instruction?______________________________

Other funding resources (please designate)

Have you ever been subject to discipline, suspension or probation at any institution of post-secondary education for reasons not related to academic performance?

Yes ____ No ____ If yes, at what institution?

Have you ever been convicted of a criminal offense involving physical injury to persons or property or otherwise institutionalized for conduct causing physical injury to persons or

property? Yes____ No ____ If yes, explain

Applicant's Full Legal Signature

I certify that the information in this application is true and

Date

complete to the best of my knowledge and I understand

that inaccurate information may affect my

admission,

enrollment, and/or financial aid status.

Revised 02/14