WAGNER COLLEGE
STATEN ISLAND, NEW YORK 10301

APPLICATION FOR NON-DEGREE ADMISSION

This application is to be used by students who wish to take Wagner College courses, for credit or audit, without
enrolling in a degree program at the College. These non-matriculated students include auditors, post-baccalaureate
students, and visiting students. Non-degree students are not normally permitted to take graduate courses unless they
have already earned a master’s degree. Applicants for non-degree admission will be asked to present transcripts
before being admitted. This application must be submitted to the Admissions Office and approved before you
attempt to register.

$20.00 Application Fee

NAME_______________________________________________________________________
(last name) (first) (middle)

SOCIAL SECURITY #_______ _______ _______

ADDRESS ____________________________________________________________________
______________________________________________________________________________
(city) (state) (zip)

TELEPHONE Home (____)__________________ Cell (____)________________________

E-MAIL __________________________________@_________________________________
APPLICATION INFORMATION
Semester applying for: ___ Fall ___ Spring ___ Summer
List the course(s) you are planning to take and your reasons for doing so:
Course Reason Credit/Audit
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Do you intend to transfer these credits to another institution ____ Yes ____ No
If yes, indicate institution name and address________________________________________
______________________________________________________________________________
You must obtain prior approval from this institution to ensure they will grant credit.
BIOGRAPHICAL INFORMATION
____ Male Date of Birth ________________________________________________
____ Female Place of Birth ________________________________________________
Maiden (or other name used) ________________________________________________________

Country of Citizenship___________________________________________________________
(Optional) Marital Status: ____ Single ____ Married _____ Divorced
(Optional) How would you describe yourself? For Department of Education reports.
___ American Indian or Alaskan Native ___ Hispanic (including Puerto Rican)
___ Asian or Pacific Islander ___ White, non-Hispanic
___ Black, non-Hispanic

EDUCATIONAL HISTORY

Beginning with secondary school, list all schools, colleges and/or universities attended:
School Name/Location Dates Attended Degree Received
______________________________________________________________________________
____________________________________________________________________________
______________________________________________________________________________

Have you ever been subject to academic disciplinary action (probation, suspension?)
___ Yes ___ No If yes, please describe (including dates)
______________________________________________________________________________

Have you previously applied for admission to Wagner College? ___ Yes ___ No

If yes, please provide semester of previous application ____________________________

I swear that all information provided in this application is complete and accurate. If admitted to Wagner
College as a non-degree student, I pledge myself to observe all regulations of the College.

SIGNATURE ______________________________________________ DATE _____________