PART-TIME APPLICATION for ACADEMIC YEAR 2024-2025 

Certificate of Intelligence Studies and 

Continuing Education

DEMOGRAPHIC INFORMATION

Gender, race, and ethnicity are not mandatory fields, but the information helps NIU assess diversity, equity, and inclusion efforts. 

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NAME (LAST, FIRST, MIDDLE) RANK/PREFIX OTHER LEGAL LAST NAMES USED 

 (e.g., CPT, Ms., Dr.) (e.g., maiden) 

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SSN DOB (DD/MM/YYYY) GENDER ETHNICITY RACE 

CONTACT INFORMATION 

NIU sends correspondence to personal and unclassified work email addresses.

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STREET ADDRESS CITY STATE ZIP 

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PERSONAL EMAIL ADDRESS 

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UNCLASSIFIED WORK EMAIL ADDRESS 

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SECURE WORK EMAIL ADDRESS 

(IF APPLICABLE) 

__________________________________________ 

PERSONAL PHONE NUMBER 

__________________________________________ 

UNCLASSIFIED WORK PHONE NUMBER 

__________________________________________ 

SECURE WORK PHONE NUMBER 

(IF APPLICABLE) 

EMPLOYMENT INFORMATION 

NIU verifies security clearances based on your SSN and the information provided below. 

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 SECURITY CLEARANCE/ACCESS SSBI DATE (mm/yyyy)

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 IF NOT, PLEASE PROVIDE YOUR ORGANIZATION 

 _________________________________________________

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PLEASE SELECT EMPLOYMENT CATEGORY IF MILITARY, PLEASE SELECT SERVICE 

(THESE ANSWERS MUST REFLECT THE FEDERAL GOVERNMENT/DOD ORGANIZATION THAT HOLDS YOUR CLEARANCE) 

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PLEASE INDICATE IF YOU WORK FOR AN IC ORGANIZATION ON THIS DROPDOWN LIST 

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NAME OF OFFICE OR MILITARY UNIT POSITION TITLE 

 _______________________________

 CAREER FIELD 

 (e.g., Analysis, Collection, IT, Security)

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FEDERAL PAY GRADE/BAND 

or MILITARY RANK OR (e.g., 

GS-13, Band 3, E-5, O-4)

__________________________

FEDERAL JOB SERIES or 

MILITARY MOS/FUNCTIONAL 

AREA (e.g., GS-0132, FA-52, 

1N1X1) 

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YEARS OF FEDERAL AND/OR 

MILITARY SERVICE 

ACADEMIC HISTORY 

➢ Undergraduate degrees must be from regionally accredited institutions; nationally accredited degrees are not accepted.

➢ Official transcripts must be sent directly from the institution(s) below to NIU Admissions; unofficial copies are not accepted.

➢ Foreign transcripts must be submitted with an official transcript evaluation from an approved foreign credentialing evaluation service.

➢ Official undergraduate transcripts must be sent even if a graduate degree was earned.

INSTITUTION LOCATION MAJOR GPA DATE DEGREE 

COMPLETED AWARDED 

(MM/YYYY) (BA, MS, PhD) 

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PROGRAM AND LOCATION SELECTION 

IMPORTANT: 

➢ Applicants may only apply to one of the programs below.

➢ Applicants must specify the location of the program they are applying to.

➢ Once admitted to a program below, only two courses (6 credits) can apply to a future MSSI/MSTI degree.

➢ Applicants to the Leadership and Management in the IC Certificate must provide a nomination from an authorizing official (form is

available on NIU's website) at their home organization, resume, and 500 word statement of purpose.

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PRINTED NAME SIGNATURE DATE (DD/MM/YYYY)

U.S. Postal Service: 

Office of Admissions 

Roberdeau Hall 

Washington, DC 20511 

UPS or FedEx (Monday-Friday Only) 

Office of Admissions 

Roberdeau Hall, ICC-B Gate 5 

1000 Colonial Farm Road 

McLean, VA 22101 

If preferred, the Office of Admissions will accept hand delivered items at the main campus in Bethesda, MD. This includes official 

transcripts in a sealed envelope and any other required application items. To arrange for this, or confirm receipt of application

materials, please email NIU_Admissions@niu.odni.gov.

PRIVACY ACT STATEMENT: The Privacy Act of Public Law 93-579 requires Federal Agencies which collect personal information from individuals to inform each 

individual of the following: 1. Authority: 44USC3101 and 3102 Establishment of Program Management.2. Principal Purpose(s): To record information solicited from 

and furnished by individuals nominated to attend courses of instruction of the NIU. 3. Routine Uses: Used in preparation of tentative and final class rosters for official 

NIU use, biographic data on students, statistical studies, attendance verification, historical records, alumni surveys, academic/fitness reports, and other official 

correspondence. 4. Disclosure and Effects: Disclosure of information by the applicant is voluntary. However, non-disclosure may result in errors in reporting course 

completion, incomplete statistical comparisons, non-receipt of security clearance, errors in historical files, incomplete student academic/fitness reports, and nonreceipt of official correspondence.

Certificate of Intelligence Studies Please select certificate topic and location.

Continuing Education

 

Email application materials to NIU_Admissions@niu.odni.gov. If materials must be sent by mail, please use the addresses below:

Please select location.

NIU Main Campus 

Southern Academic Center -->

European Academic Center -->

NSA Academic Center -->

Quantico Academic Center 

NGA St. Louis

CHOOSE FROM ALL 12 CERTIFICATE TOPICS NIU Main Campus -->

Strategic Intelligence in Special Operations Southern Academic Center -->

Africa: Strategic Intelligence Studies European Academic Center -->

Counterintelligence Quantico Academic Center

China: Intelligence Concerns USINDOPACOM

Please choose specific topic from the drop down menu.

Please choose specific location at the Southern Academic Center.

Please choose specific location at the European Academic Center.

Please choose specific location at the Southern Academic Center.

Please choose specific location at the European Academic Center.

Please choose specific location at the NSA Academic Center.

AFFIRMATION

I hereby certify the information provided by me is my own work and is true, complete, and accurate. I understand and agree that any

deliberate misrepresentation may be cause for denial or revocation of admission or subsequent dismissal from NIU. I understand all

admission materials submitted in support of this application become part of my NIU record and are not returnable.