Application For Admission Under The Agreement On Graduate Education Page 2
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1
2Office of Graduate Studies of HOME Institution completes this section.
Please be sure all questions are
answered:
This is to certify that the above named individual is a Graduate Student in good standing at this institution. He/She has our permission to take the
following course(s) at the:
University of Missouri – Kansas City
University of Kansas Medical Center
The course(s) taken under this agreement count as resident credit toward graduation. Maximum of six credit hours per semester. This course(s) is a
part of the student’s graduate program or a prerequisite for the program.
Course Title
Subject
Catalog #
Class #
Credit Hours
Instructor
GTA/RA/GRA Appointment Information:
Student is eligible for GTA/RA/GRA appointment for the semester of enrollment under this agreement: YES
NO
This GTA/GA/GRA appointment must meet the minimum qualifications for the waiver of non-resident tuition at the HOME SCHOOL.
Comments:
This applicant is eligible for enrollment at host institution
YES
NO
Graduate Advisor Signature:
Print Name:
Phone # and E-mail Address:
Date of Approval:
Dean of Graduate School Signature:
Print Name:
Phone # and E-mail Address:
Date of Approval:
Registrar’s Office of HOME institution completes this section:
Student is: Resident for Tuition Purposes
Non Resident for Tuition Purposes
*ATTENTION STUDENT: If you are a Non-Resident at the home school but live in the state of the host school, you may qualify for resident
tuition rates. Contact the Registrar’s Office at the Host Institution for more details.
Home Registrar Signature:
Print Name
Phone and E-mail Address:
Date of Approval:
Send completed application to the appropriate HOST school at the address below:
KUMC
UMKC
Office of the Registrar
Registration and Records
3001 Student Center
University of Missouri – Kansas City
University of Kansas Medical Center
115 Administrative Center
Mail Stop 4029
5115 Oak Street
3901 Rainbow Blvd
Kansas City, MO 64110
Kansas City, KS 66160
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