APPLIC A TION FOR ADMISSION TO GRADUATE STUDIES IN

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Admissions Office PO Box 5000 Antigonish Nova Scotia Canada B2G 2W5 Toll-Free: 1-877-867-StFX (7839) or 1-902-867-2219 (local) Fax: (902) 867-2329 Email: admit@stfx.ca APPLIC A TION FOR ADMISSION TO GRADUATE STUDIES IN CHECK ONE Adult Education (M.Ad.Ed.) Education (M.Ed.) Educational Administration and Policy (Cohort: ) Curriculum and Instruction (Cohort: ) non-degree student Students are encouraged to contact the department in which they wish to study prior to applying to a graduate program. COMPLETION GUIDE In order to help us process your application as efficiently as possible, please ensure that you complete all sections. The following documents should be sent to the Admissions Office. a) This application form, complete in all its details, with the non-refundable application fee of $40. b) Two letters of recommendation from persons named in this application. (see insert pages) c) One official copy of your transcript from each postsecondary institution attended. Graduates of StFX do not need to provide a copy of their transcript from StFX. d) Evidence of English proficiency if your first language is not English (contact the Admissions Office for details) e) For applicants to the Master of Education program, a recent curriculum vitae and a supplementary "letter of intent" are required (see page 3) f) For applicants to the Master of Adult Education program, a recent curriculum vitae and a typed statement are also required (see page 3) It is the responsibility of the applicant to ensure that all SUPPORTING DOCUMENTS are received by the StFX Admissions Office. Applications cannot be processed until such documents are received. NOTE: Admission to Graduate Studies is determined by the University Committee on Graduate Studies. APPLICANT Mr. Ms. Mrs. Other Last Name: First Name: Middle Name: Preferred First Name: Previous Last Name (if applicable): CURRENT MAILING ADDRESS Street Address/PO Box/Rural Route #: City: Province/State: Postal Code/ZIP: Country: Phone: Fax: Email: PERMANENT MAILING ADDRESS (if different from above) Street Address/PO Box/Rural Route #: City: Province/State: Postal Code/ZIP: Country: Phone: Fax: Email: WHEN DO YOU PLAN TO BEGIN THE PROGRAM? Master of Adult Education: (Month/Year) / Master of Education: Summer Session Part-time Full-time Students must adhere to the appropriate deadlines for the submission of applications to their intended program of study.

PERSONAL INFORMATION Gender: Date of birth: Day Month Year Citizenship: SIN/SSN: Previous surname(s): StFX Student number (if applicable): Ethnic Origin (Optional): Aboriginal African Descent Other LANGUAGE(S) First language spoken: Other languages spoken: Languages written: EMERGENCY CONTACT Mr. Ms. Mrs. Other Last Name: First Name: Relationship to Applicant: Complete the following only if different from Permanent Address Street Address/PO Box/Rural Route #: City: Province/State: Postal Code/ZIP: Country: Phone: Fax: Email: COLLEGES OR UNIVERSITIES ATTENDED: College or University DatesAttended Major Fields Degree/Diploma/ Certificate Granted/ Credits Completed PLEASE LIST ALL GRADUATE PROGRAMS PREVIOUSLY APPLIED TO BY COMPLETING THE FOLLOWING: College or University Program Date of Application Were you accepted? Did you enroll?

WORK EXPERIENCE List major work experience here. Indicate length of time in each. Master of Adult Education and Master of Education applicants are asked to include a resume/curriculum vitae. REFERENCES Provide the names and addresses of two people who could give an accurate appraisal of your scholastic and professional ability and who might give an opinion about your suitability for graduate study. If possible, one of these should be a person who taught you in your most recent academic program. Provide them with the applicant reference form and a stamped envelope addressed to the Admissions Officer, St. Francis Xavier Univeristy, Box 5000, Antigonish, Nova Scotia B2G 2W5. 1. 2. In a few sentences, indicate why you are selecting this graduate program and what you hope to gain from it. MASTER OF EDUCATION APPLICANTS ONLY: Please attach 1. a curriculum vitae or resume 2. a Letter of Intent (up to 250 words) indicating why you are selecting the Master of Education graduate program at StFX and what you hope to gain from it. MASTER OF ADULT EDUCATION APPLICANTS ONLY: Please attach 1. a comprehensive curriculum vitae clearly indicating your experience in the practice of adult education. 2. a typed statement of 500-1000 words (maximum) discussing: your personal philosophy of adult education; your experience as an adult educator; your long-term career goals; an indication of your area of interest

ADDITIONAL INFORMATION Please use the following space to include any additional information which you feel would be of help to us in making an admission decision. CHECKLIST FOR APPLICANTS Application form is complete in all its details Non-refundable application fee of $40. Have requested two letters of recommendation from persons named in this application Have requested one official copy of transcript from each post-secondary institution attended. (Graduates of StFX do not need to provide a copy of their transcript from StFX.) Evidence of English proficiency if your first language is not English (contact the Admissions Office for details). For applicants to the Master of Education: have enclosed a recent curriculum vitae and the supplementary "letter of intent" (see page 3). For applicants to the Master of Adult Education: have enclosed a recent curriculum vitae and the required statement (see page 3). PLEASE NOTE: It is the responsibility of the applicant to check with the Admissions Office to ensure that all of the above documents have arrived Date: Signature: HAVE ALL DOCUMENTS SENT TO: Admissions Office St. Francis Xavier University PO Box 5000 Antigonish, Nova Scotia Canada B2G 2W5 Fax: 902-867-2329

APPLICANT REFERENCE Please provide this sheet to the people whom you have chosen to act as references on your behalf. Once complete, the referee should forward this reference directly to the StFX Admissions Office at the following mailing address: Admissions Office, St. Francis Xavier University, PO Box 5000, Antigonish, Nova Scotia, Canada B2G 2W5 Referees may email scanned copied to admit@stfx.ca Faxed copies will also be accepted and can be sent to 1-902-867-2329 Name of Applicant: first name middle name last name Program applied to: Excellent Very Good Satisfactory Unsatisfactory No Basis for Judgement Comments Scholastic Ability Integrity Initiative Oral Expression Written Expression Leadership Judgement Problem-Solving Abilities Organizational Abilities Self-directed Willingness to take direction Interpersonal Skills Overall Assessment

How long and in what capacity have you known the applicant Based on your knowledge of the individual, do you recommend him/her for admission to StFX? Yes No What do you consider to be the applicant s strongest assets? What do you consider to be the applicant s major limitations relevant to graduate studies? What particular attributes and skills does the applicant possess that prepare him/her for university-level study?

Please note any contributions you may be aware of that the applicant has made to his/her community or school: Please elaborate on previous comments or provide additional ones (use a separate sheet if required): Signature: Date: Name: Address: Position: Telephone: Email: PLEASE SEND TO: The Admissions Office St. Francis Xavier University 5005 Chapel Square, Antigonish, Nova Scotia, Canada B2G 2W5 Fax: 902-867-2329 Email: admit@stfx.ca