Application for Admission Graduate Certificate Program in Gerontology

This Application is for students currently or previously enrolled in a graduate
program from Wayne State University (WSU).

Applicants who are not WSU
graduates must apply directly to the graduate school at
http://gradapply.wayne.edu and follow the instructions.

Graduate Certificate Program
in Gerontology
Wayne State University
School of Social Work
5447 Woodward Ave,
Detroit, Michigan 48202
Phone : (313)-577-4409
Fax : (313)-577-4266

Fields with asterisks (*) are required.

Application for Fall Semester:

Gender

Name, Address, and Telephone Number of Person(s) to be notified in case of emergency:

Citizenship:

Country of Citizenship
Are you a resident of Michigan?

Ethnicity:

This information is requested on a voluntary basis to fulfill reporting obligations of the School of Social Work and the University. Please identify your ethnic background by checking the appropriate box:

United States (includes non-citizens with resident visas)
Foreign
Type of Visa

Term in which you expect to begin Certificate in Gerontology Program course work:

Term

Please list, in chronological order, all colleges/universities you have attended:

Undergraduate Colleges or Universities:

Graduate School:

Official Transcripts of Undergraduate and Graduate Study

You will also need to include the following items with this application:

a.) Resume: Upload a current resume, not to exceed two pages

b.) Personal Statement: Briefly describe your interest and your reason for applying to the Graduate Certificate in Gerontology Program. What special experiences, goals, and objectives do you bring to this program that support or strengthen your interests in working in the field of aging? Your personal statement should be one to two pages in length and should be sent or delivered to the address on the top of page one.

c.) Transcripts: Submit an official transcript for all undergraduate and graduate programs attended. (unofficial copies are acceptable)

d.) Course Work: A plan of work will need to be completed at your personal interview with the admissions advisor for the Graduate Certificate Program. A total of 12 credit hours are required.

References

Each applicant is asked to request letters of references from two (2) individuals (copies of the request letter are included in the application packet). One letter needs to come from an academic advisor or someone who is knowledgeable regarding your academic abilities, and one from an individual who you have worked with and, if applicable, knows your work with older adults. The letter should be sent to the address on the first page at the top of the form. Please enter names of your references with their contact information.

Reference 1

Reference 2

Have you ever been convicted of a felony?

Statement of Certification

I hereby apply for admission to the Graduate Certificate Program in Gerontology in the School of Social Work, Wayne State University, and certify that the information in this application is correct and complete. I understand that information submitted herein will be relied upon by officials of Wayne State University School of Social Work to determine my status for admission eligibility. Further, I understand that submission of false information is grounds for rejection of my application, cancellation of enrollment, or appropriate disciplinary action.

NOTICE : IT IS THE POLICY AND PRACTICE OF WAYNE STATE UNIVERSITY THAT ALL PROGRAMS ARE AVAILABLE TO ALL STUDENTS WITHOUT REGARD TO RACE, SEX, CREED, NATIONAL ORIGIN OR HANDICAP STATUS.