Applicant's Name:

_______________________________________________________________________________
Last
First
Middle


Social Security No.

_______________________________Today's date: _____________________________________


Home Address:

______________________________________________________________________________


Home Phone:

(______)________________________E-mail:__________________________________________


Work Address:

_______________________________________________________________________________


Country of Citizenship:

__________________________________If US, the state where you claim residence:____________
When were you admitted to the MA in Spanish Program?

__________________________________Date you expect to receive M.A. degree:______________
When do you wish to begin a Teaching Assistantship

__________________ Semester, 200______
 
Number of Spanish graduate credits (if any) you expect to have completed before beginning
the Teaching Assistantship_____________
Scholarships held to date:
____________________________________________________________________

____________________________________________________________________
Other honors received:
____________________________________________________________________

____________________________________________________________________
Publications or scholarly productions:
____________________________________________________________________

____________________________________________________________________
Professional Certification:
____________________________________________________________________
Briefly describe any study abroad experiences (program, country, length of stay)
____________________________________________________________________

____________________________________________________________________

____________________________________________________________________
Self evaluation of language proficiencies:
In Spanish (native / near native / average / below average):___________________________________

In English (native / near native / average / below average):___________________________________


Explain briefly:
____________________________________________________________________
 

Return completed application to:
Spanish Graduate Advisor, Department of Spanish, 1903 W. Michigan Avenue
Western Michigan University, Kalamazoo, MI 49008-5338
or FAX to (269) 387-3103.