Application Information
MA-ORGL Electronic Application Form (Campus-based)
MA-ORGL Paper Application Form

MA-ORGL Electronic Application Form (Campus-based)

Please print out and sign the signature page ( 48KB) and fax or mail to:

Connie Caddis

Gonzaga University School of Professional Studies

502 E. Boone, MSC 2616

Spokane, WA   99258

Fax: 509-313-3574

caddis@gonzaga.edu
Personal Information:
Last Name:
First Name:
Middle Name:
Former Last Name(s), if any:
E-Mail Address (required):
Male      Female
Birth Date: / /
Student ID#:
Country of Citizenship:
Visa Type or Alien Registration #:
Ethnic Origin (Optional):
Class will be attended in the:
Mailing Address:
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Address Valid Until:
Permanent Address (if different than Mailing Address):
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Business Address:
Business:
Title:
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax #:

Degree of Interest:
School of Professional Studies
Master of Organizational Leadership

Entrance Exam
MAT - Test Date:
(mm/dd/yy)		 GMAT - Test Date:
(mm/dd/yy)
GRE - Test Date:
(mm/dd/yy)		 LSAT - Test Date:
(mm/dd/yy)
TOEFL - Test Date:
(mm/dd/yy)		      
Beginning Term: Year:
Have you ever attended Gonzaga University?
Yes No If yes, when?

Educational History (in order of attendance)
(Post-Master's Certificate applicants list graduate study institutions only)
College/University:
From/To: to
City:
State/Province:
Zip/Postal Code:
Degree/Diploma:
Date Received:
College/University:
From/To: to
City:
State/Province:
Zip/Postal Code:
Degree/Diploma:
Date Received:
College/University:
From/To: to
City:
State/Province:
Zip/Postal Code:
Degree/Diploma:
Date Received:
College/University:
From/To: to
City:
State/Province:
Zip/Postal Code:
Degree/Diploma:
Date Received:
If participating in off-campus, name site:
Employment History
Employer:
Title:
Supervisor:
From/To: to
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Phone:
Reason for Leaving:
Work Experience:
Employer:
Title:
Supervisor:
From/To: to
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Phone:
Reason for Leaving:
Work Experience:
Employer:
Title:
Supervisor:
From/To: to
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Phone:
Reason for Leaving:
Work Experience:
Post-Master's Certificate Applicants, list the major focus of your Master of Science in Nursing and the year completed:
Special training in the field pertaining to your degree program:
Given the Mission of Gonzaga University and the campus spirit we try to create, we ask whether you have ever been convicted of a crime or have a case pending against you at this time.
No      Yes
If yes, please provide written details:
In Case of Emergency, please notify:
Name:
Relationship:
Address:
Address cont.:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Equal Opportunity Policy: Gonzaga is an equal opportunity, affirmative action University. The University does not discriminate against any person on the basis of race, religion, sex, national origin, age, marital or veteran status, sexual orientation, physical or mental impairment that limits a major life activity, or any other non-merit factor in employment, educational programs, or activities which it operates. All University policies, practices, and procedures are consistent with Gonzaga's Catholic, Jesuit identity and Mission Statement.

504 Policy: Federal Law prohibits us from making a pre-admission inquiry about disabilities. Information regarding disabilities, voluntarily given or inadvertently received, will not adversely affect any admission decisions. If you require special services because of a disability, you may notify the Dean of Students' Office. This voluntary self-identification allows Gonzaga University to prepare appropriate support services to facilitate your learning. This information will be kept in strict confidence and has no effect on your admission to the University.