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Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Certificate Program | Unnamed: 34 | Unnamed: 35 | Unnamed: 36 | Unnamed: 37 | Unnamed: 38 | Unnamed: 39 | Unnamed: 40 | Unnamed: 41 | Unnamed: 42 | Unnamed: 43 | Unnamed: 44 | Unnamed: 45 | Unnamed: 46 | Unnamed: 47 | Unnamed: 48 | Unnamed: 49 | Unnamed: 50 | Unnamed: 51 | Unnamed: 52
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Application Form
 | All responses must be printed or typed.
1 | FULL Legal Name:
 |  |  |  |  |  |  |  |  |  |  |  | PREFIX |  |  |  | LAST |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | FIRST AND MIDDLE |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SUFFIX
 | Preferred Name(s):
 | Any other name(s) under which your documents might be received:
2 | Social Security Number: |  |  |  |  |  |  |  |  |  |  |  |  |  | – |  |  | – |  |  |  |  |  | 3 | Sex: |  |  | q | Male |  |  | q | Female
3 | Date & Place of Birth:
 |  |  |  |  |  |  |  |  |  |  |  | MONTH |  |  | DAY |  |  | YEAR |  |  |  | CITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATE |  |  | COUNTRY
4 | Religious Affiliation:
 | (OPTIONAL)
5 | Country of Citizenship: |  |  |  |  |  |  |  |  |  | q | United States |  |  |  |  |  |  |  | q | Other
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | COUNTRY OF CITIZENSHIP OTHER THAN U.S.
 | If you're not a U.S. citizen, are you currently living in the United States? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Yes |  |  |  |  |  | q | No
 | If you're a Non-Immigrant, what is your current visa status? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | F-1 |  |  | q | J-1 |  |  | q | B-1 |  |  | q | H-1, L-1, [NAME] or A-1 |  |  |  |  |  |  |  | q | Other - Please State
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | F-2 |  |  | q | J-2 |  |  | q | B-2 |  |  | q | H-4 |  |  |  |  |  |  |  | q | Need |  |  |  |  |  |  | VISA
 | If you're a Permanent Resident, what is your alien card identification:
6 | Military Status: |  |  |  |  |  |  |  | q | Active |  |  |  | q | Reservist |  |  |  |  | q | Veteran Claiming Benefit (below) |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Non-Veteran |  |  |  |  |  | q | Veteran not Claiming Benefit
 |  |  |  |  |  |  |  |  |  |  |  | q | PL 634 Dependents |  |  |  |  |  |  |  |  | q | PL 894 Rehab |  |  |  |  |  |  | q | PL 358 Cold War |  |  |  |  |  |  |  | q | [NAME] |  |  |  |  |  |  | q | PL 550 Korean
7 | Residence Address:
 | (CURRENT MAILING ADDRESS) |  |  |  |  |  |  |  |  |  |  | STREET AND NUMBER
 |  |  |  |  |  |  |  |  |  |  |  | CITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATE/COUNTRY |  |  |  |  |  | ZIP CODE
8 | Permanent Address:
 | (IF DIFFERENT FROM ABOVE) |  |  |  |  |  |  |  |  |  |  | STREET AND NUMBER
 |  |  |  |  |  |  |  |  |  |  |  | CITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATE/COUNTRY |  |  |  |  |  | ZIP CODE
9 | Business Address:
 |  |  |  |  |  |  |  |  |  |  |  | STREET AND NUMBER
 |  |  |  |  |  |  |  |  |  |  |  | CITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATE/COUNTRY |  |  |  |  |  | ZIP CODE
10 | Contact Information: |  |  |  |  |  |  |  |  |  |  |  |  |  | – |  |  |  | – |  |  |  |  |  |  |  |  |  |  | – |  |  |  | – |  |  |  |  |  |  |  |  |  |  | – |  |  |  | –
 |  |  |  |  |  |  |  |  |  |  |  | RESIDENCE |  |  |  |  |  |  |  |  |  |  |  |  |  |  | BUSINESS |  |  |  |  |  |  |  |  |  |  |  |  |  |  | FAX
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q PERSONAL              q BUSINESS                q SCHOOL
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | @
 |  |  |  |  |  |  |  |  |  |  |  | E-MAIL ADDRESS
11 | Employment Experience (beginning with most recent):
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Dates |  |  |  |  |  |  |  | Full-Time
 | Employer |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | From |  |  |  | To |  |  |  | or Part-Time |  |  |  |  |  |  |  |  |  |  |  | Nature of Work
 | Current:
12 | Please check all the categories that apply to you.  (PLEASE NOTE THAT THIS INFORMATION IS FOR STATISTICAL PURPOSES ONLY AND YOU MAY DECLINE TO ANSWER.)
 |  | q | American Indian/Alaskan Native |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Hispanic |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Black, Non-Hispanic
 |  | q | Asian |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | White |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Native Hawaiian/Other Pacific
 |  |  |  |  | Providing this information is voluntary.  The information you choose to provide will be used in a nondiscriminatory manner, consistent with applicable civil rights laws, solely for required reporting under federal and/or state laws.
13 | Colleges and universities (including SMU) in which you have registered for any course work, whether or not credit was earned or a grade received.  Include all degrees and dates awarded.  An official transcript must be submitted for EACH college and university attended.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Dates of Attendance |  |  |  |  |  |  |  |  |  | Major |  |  |  |  |  |  |  |  |  |  |  | Date
 | College or University |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Location |  |  |  |  |  |  |  |  |  | From |  |  |  |  | To |  |  |  |  | Field |  |  |  |  |  |  |  | Degree |  |  | † | Received
 | MOST RECENT:
 |  | † | Give initials of the exact degree title as it appears on your diploma; e.g., BS, BSEE, BEE, MS, MSME.
14 | Desired [NAME] and Status: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Fall |  |  | q | Spring |  |  |  | q | Summer |  |  |  |  |  |  |  |  |  | q | Full-Time |  |  |  |  | q | Part-Time
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | YEAR
15 | Test Scores: |  |  |  |  |  |  | TOEFL  (INTERNATIONAL H1B AND H4 STUDENTS ONLY!  ALL OTHER INTERNATIONAL STUDENTS, PLEASE REFER TO #22 BELOW!)
16 | Desired Source of Study: |  |  |  |  |  |  |  |  |  |  |  |  | q | Main-Campus |  |  |  |  |  |  |  |  | q | Distance Education
17 | Indicate the date of any previous admission application to SMU:
18 | Criminal History: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | MONTH |  |  |  | YEAR
 | [NAME] you currently under indictment for any crime? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Yes |  | q | No
 | [NAME] you ever been convicted of, pleaded guilty to, or received, deferred adjudication for any felony, state jail felony,
 |  | or Class A misdemeanor? |  |  |  |  |  |  |  |  |  |  |  |  | q | Yes |  | q | No
 | [NAME] you ever received, or are you currently on probation? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Yes |  | q | No
 | (Disclosure in the affirmative will not necessarily result in rejection of an applicant for admission.  Failure to disclose such a record, if it exists,
 | and to explain that record honestly, however, may result in your dismissal from the University.  Failure to explain an affirmative response to
 | this question will result in the Application's not being further processed).
19 | Have you ever been dismissed from, suspended from, or denied admission to any school, college or university? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | IF SO, PLEASE EXPLAIN.
20 | Please indicate the desired department and certificate program.
 |  | Department |  |  |  |  |  |  |  |  |  | Certificate Series |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Certificate
 |  |  |  | CSE |  |  |  |  |  |  |  | Core Curriculum |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Software Engineering Fundamentals
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Software Requirements Engineering
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Software Design Engineering
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Software Construction Engineering
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Software Testing and Quality Engineering
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Distributed Computing Technologies
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Software Engineering Management
 |  |  |  | CSE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Computer Security and Information Assurance
 |  |  |  | EMIS |  |  |  |  |  |  |  | Core Curriculum |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Systems Engineering Fundamentals
 |  |  |  | EMIS |  |  |  |  |  |  |  | Core Curriculum |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Systems Analysis
 |  |  |  | EMIS |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Systems Design & Development
 |  |  |  | EMIS |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Reliability & Logistics Systems Engineering
 |  |  |  | EMIS |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Enterprise Management
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Environmental Management and Compliance
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Occupational Health and Industrial Hygiene
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Pollution Control and Prevention
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Facilities Management
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Water Quality Engineering
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Hazardous and Waste Materials Management
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Air Quality Engineering
 |  |  |  | ENCE |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | q | Sustainability
21 | Special Considerations:  Software Engineering, Systems Engineering and ENCE Certificate Series
 | Students pursuing Software Engineering, Systems Engineering and ENCE certificates may apply for admission to the Masters degree
 | at any point in the series, as long as they meet the admissions criteria.  Upon admission, graduate courses successfully completed
 | may be applied toward the Masters degree as applicable.
22 | Special Considerations:  International Policy Statement
 | Certificate programs are structured as part-time offerings.  Therefore, they do not lend themselves to the INS requirements imposed on
 | a full-time student visa.
23 | Please write a statement concerning your goals for certificate studies at SMU's [NAME] of Engineering and attach it to
 | the application. (The form and content of your statement will be given careful consideration by Department Admissions Committee.)
24 | Intellectual integrity and academic honesty are fundamental to the process of learning and evaluating academic performance, and maintaining
 | them is the responsibility of all members of an educational institution.  The inculcation of personal standards of honesty and integrity is a
 | goal of all members of an educational institution.  The inculcation of personal standards of honesty and integrity is a goal of education in all
 | the disciplines of the University.  Students and faculty must mutually share the knowledge that any dishonest practices permitted will make it
 | more difficult for the honest students to be evaluated and graded fairly and will damage the integrity of the whole University.  Students
 | should recognize that both their own interests, and their integrity as individuals, suffer if they condone dishonesty in others.  All students at
 | SMU have the responsibility to uphold the integrity of their own education.  There are two basic Honor Code violations that each student
 | should be aware of: 1) giving and receiving of unauthorized aid and 2) plagiarism.  By signing this application, I understand that any breach of
 | the Honor Code is considered a serious violation of University standards.  I am aware that it is my responsibility to abide by the SMU Honor
 | Code.  I further agree that upon acceptance of the offer of admission to bind myself to the terms and conditions of the SMU Honor Code.
 | I certify that all statements made in this application for admission to the graduate program at the Bobby B. Lyle School of Engineering are correct to the best of my knowledge.  I realize that all documents submitted in support of this application become the property of SMU.  I understand and agree that any misrepresentation or omission of facts in my application will justify the denial of admission or the cancellation of admission.
 | (a) |  | Date: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | (b) |  | Signature: