LAST NAME FIRST NAME MIDDLE NAME. PLACE OF BIRTH (Please include country if other than U.S.) CITY STATE ZIP CODE CITY STATE ZIP CODE

Similar documents
EMPLOYMENT APPLICATION Legislative Counsel Bureau and Nevada Legislature 401 S. Carson Street Carson City, NV Equal Opportunity Employer

New Student Application. Name High School. Date Received (official use only)

Application and Admission Process

JD Concentrations CONCENTRATIONS. J.D. students at NUSL have the option of concentrating in one or more of the following eight areas:

KENT STATE UNIVERSITY

The Demographic Wave: Rethinking Hispanic AP Trends

Freshman Admission Application 2016

DUAL ENROLLMENT ADMISSIONS APPLICATION. You can get anywhere from here.

SMILE Noyce Scholars Program Application

International Undergraduate Application for Admission

National Survey of Student Engagement The College Student Report

SFY 2017 American Indian Opportunities and Industrialization Center (AIOIC) Equity Direct Appropriation

Upward Bound Math & Science Program

University of Utah. 1. Graduation-Rates Data a. All Students. b. Student-Athletes

APPLICANT INFORMATION. Area Code: Phone: Area Code: Phone:

ACHE DATA ELEMENT DICTIONARY as of October 6, 1998

Application for Admission

Application for Full-Time Freshman Admission

Application Paralegal Training Program. Important Dates: Summer 2016 Westwood. ABA Approved. Established in 1972

Arizona GEAR UP hiring for Summer Leadership Academy 2017

Meeting these requirements does not guarantee admission to the program.

UW-Waukesha Pre-College Program. College Bound Take Charge of Your Future!

INSTRUCTIONS FOR COMPLETING THE EAST-WEST CENTER DEGREE FELLOWSHIP APPLICATION FORM

ADULT VOCATIONAL TRAINING PROGRAM APPLICATION

Bellevue University Admission Application

Application for Admission to Postgraduate Studies

Juris Doctor (J.D.) Program

California State University, Los Angeles TRIO Upward Bound & Upward Bound Math/Science

TRANSFER APPLICATION: Sophomore Junior Senior

Bachelor of Arts in Gender, Sexuality, and Women's Studies

CIN-SCHOLARSHIP APPLICATION

Institution of Higher Education Demographic Survey

Cy-Fair College Teacher Preparation and Certification Program Application Form

West Hall Security Desk Attendant Application

Discrimination Complaints/Sexual Harassment

The Louis Stokes Scholar Internship A Paid Summer Legal Experience

Instructions & Application

Cypress College STEM² Program Application

Table of Contents. Internship Requirements 3 4. Internship Checklist 5. Description of Proposed Internship Request Form 6. Student Agreement Form 7

Tamwood Language Centre Policies Revision 12 November 2015

Iowa School District Profiles. Le Mars

EMPLOYEE DISCRIMINATION AND HARASSMENT COMPLAINT PROCEDURE

Please complete these two forms, sign them, and return them to us in the enclosed pre paid envelope.

DEPARTMENT OF FINANCE AND ECONOMICS

Vocational Training. Pre-Application

Status of Women of Color in Science, Engineering, and Medicine

DO SOMETHING! Become a Youth Leader, Join ASAP. HAVE A VOICE MAKE A DIFFERENCE BE PART OF A GROUP WORKING TO CREATE CHANGE IN EDUCATION

46 Children s Defense Fund

A Guide to Supporting Safe and Inclusive Campus Climates

Background Checks and Pennsylvania Act 153 of 2014 Compliance. Frequently Asked Questions

IN-STATE TUITION PETITION INSTRUCTIONS AND DEADLINES Western State Colorado University

The application is available on the AAEA website at org. Click on "Constituent Groups", then AAFC and then AAFC Scholarship.

Application for Admission

ADULT VOCATIONAL TRAINING (AVT) APPLICATION

FULBRIGHT MASTER S AND PHD PROGRAM GRANTS APPLICATION FOR STUDY IN THE UNITED STATES

Non-Academic Disciplinary Procedures

Department of Social Work Master of Social Work Program

Table of Contents Welcome to the Federal Work Study (FWS)/Community Service/America Reads program.

User Manual. Understanding ASQ and ASQ PLUS /ASQ PLUS Express and Planning Your Study

GRADUATE STUDENTS Academic Year

2018 Summer Application to Study Abroad

Bellevue University Bellevue, NE

Department of Legal Assistant Education THE SOONER DOCKET. Enroll Now for Spring 2018 Courses! American Bar Association Approved

ESL Summer Camp: June 18 July 27, 2012 Homestay Application (Please answer all questions completely)

THE LUCILLE HARRISON CHARITABLE TRUST SCHOLARSHIP APPLICATION. Name (Last) (First) (Middle) 3. County State Zip Telephone

IUPUI Office of Student Conduct Disciplinary Procedures for Alleged Violations of Personal Misconduct

CLINICAL TRAINING AGREEMENT

JUNE 15, :30 PM 9:15 PM

University of Maine at Augusta Augusta, ME

Missouri 4-H University of Missouri 4-H Center for Youth Development

12-month Enrollment

Rules of Procedure for Approval of Law Schools

Southeast Arkansas College 1900 Hazel Street Pine Bluff, Arkansas (870) Version 1.3.0, 28 July 2015

Adult Vocational Training Tribal College Fund Gaming

Interview Contact Information Please complete the following to be used to contact you to schedule your child s interview.

Application for Admission. Medical Laboratory Science Program

Demographic Survey for Focus and Discussion Groups

Emergency Medical Technician Course Application

Undergraduate and Graduate Study Abroad / Exchange Application Form

Northwest Georgia RESA

GRADUATE SCHOOL DOCTORAL DISSERTATION AWARD APPLICATION FORM

HIGH SCHOOL PREP PROGRAM APPLICATION For students currently in 7th grade

Duke University. Trinity College of Arts & Sciences/ Pratt School of Engineering Application for Readmission to Duke

Guidelines for Completion of an Application for Temporary Licence under Section 24 of the Architects Act R.S.O. 1990

APPLICATION FOR ADMISSION 20

National Survey of Student Engagement (NSSE)

University of Massachusetts Amherst

ADMINISTRATIVE DIRECTIVE

Application for Postgraduate Studies (Research)

EXPANSION PACKET Revision: 2015

Disciplinary action: special education and autism IDEA laws, zero tolerance in schools, and disciplinary action

SCHOLARSHIP GUIDELINES FOR HISPANIC/LATINO STUDENTS

African American Studies Program Self-Study. Professor of History. October 9, 2015

Data Glossary. Summa Cum Laude: the top 2% of each college's distribution of cumulative GPAs for the graduating cohort. Academic Honors (Latin Honors)

Academic Affairs. General Information and Regulations

Exclusions Policy. Policy reviewed: May 2016 Policy review date: May OAT Model Policy

Organization Profile

Guide to the Program in Comparative Culture Records, University of California, Irvine AS.014

Effective Recruitment and Retention Strategies for Underrepresented Minority Students: Perspectives from Dental Students

AUTHORIZED EVENTS

Transcription:

Office of Admissions and Financial Aid 3501 Sansom Street, Philadelphia, PA 19104-6204 (215) 898-7400 www.law.upenn.edu admissions@law.upenn.edu finaid@law.upenn.edu Please fully read the Application Instructions before completing this application. Application for Visiting Admission to the Juris Doctor Program PERSONAL DATA Mr. Ms. Dr. LAST FIRST MIDDLE SOCIAL SECURITY NUMBER (last 4 digits only) L LSAC ACCOUNT NUMBER (Required) DATE OF BIRTH (MM/DD/YYYY) PLACE OF BIRTH (Please include country if other than U.S.) Are you a U.S. citizen? If no, please provide the following information: Country of citizenship if other than U.S.: If you are not a U.S. citizen, are you a permanent resident (green card holder)? Please fill out address as if you were addressing an envelope without the name. Current Address: Permanent Address: (Good until MM/DD/YYYY): / / CITY STATE ZIP CODE CITY STATE ZIP CODE (U.S. or Canadian provinces only) (U.S. or Canadian provinces only) COUNTRY (if other than U.S.) DAYTIME TELEPHONE: COUNTRY (if other than U.S.) DAYTIME TELEPHONE: CELL TELEPHONE: EMAIL ADDRESS: (List only one) APPLICATION DATA Type of Application (please check option below and refer to the Application Instructions): Spring Visiting Student Admission Have you applied to the JD Program at Penn Law in a prior year? If yes, for which year? Page 1 of 5

FAMILY BACKGROUND FATHER'S DECEASED MOTHER'S DECEASED ADDRESS (IF LIVING) ADDRESS (IF LIVING) CITY STATE ZIP (COUNTRY) CITY STATE ZIP (COUNTRY) COMPANY OR FIRM COMPANY OR FIRM OCCUPATION/TITLE OCCUPATION/TITLE HIGHEST LEVEL OF EDUCATION HIGHEST LEVEL OF EDUCATION Please list any relatives who are attending or who have graduated from Penn Law. If not applicable, please skip. ACADEMIC BACKGROUND High school name, location and year of graduation: List in order of attendance all undergraduate, graduate, and professional institutions that you have attended. Page 2 of 5

ACADEMIC INTERESTS (Optional) Please indicate the field(s) of law which you have the greatest interest in exploring as a student at Penn Law: Academic Administrative Admiralty & Maritime Antitrust Appellate Arbitration/ Mediation/ ADR Aviation Banking & Commercial Finance Bankruptcy Biotech Children Civil Rights Commercial Litigation Communications Constitutional Construction Consumer Copyright & Trademark Corporate Criminal Education Elderly Other: Employee Benefits Energy Entertainment & Sports Environmental Family General Practice Government Government Contracts Health Housing Human Rights Immigration Insurance Intellectual Property International Investment Banking Juvenile Labor & Employment Legal Services Legislative Practice Litigation Management Consulting Media & Communications Medical Malpractice Mergers & Acquisitions Military Municipal Finance Patent Poverty Products Liability Public Service Real Estate Securities Tax Technology Tort Law - Personal Injury/Insurance Defense Transportation Trusts & Estates Venture Capital White Collar Crime Worker's Comp EMPLOYMENT Please submit a résumé or CV as an attachment with your application. In addition to your professional experiences, please include any academic and/or non-academic honors you have received as well as any extracurricular and/or community activities in college and since graduation. Please account for all time periods. If you were employed while in undergraduate school during the academic year, beginning with your freshman year, list the positions you held. Hours worked per week as a: Freshman Sophomore Junior Senior REFERENCES Please provide the names of the individuals submitting letters of recommendation for you. Letters must be submitted directly to the Law School. OF REFERENCE OF REFERENCE ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP TELEPHONE TELEPHONE EMAIL ADDRESS EMAIL ADDRESS Page 3 of 5

PERSONAL STATEMENT The Admissions Committee requires that every applicant submit an original sample of written expression. The purpose of this personal statement is to provide you with as flexible an opportunity as possible to submit information that you deem important to your candidacy. You may wish to describe aspects of your background and interests - intellectual, personal or professional - and how you will uniquely contribute to the Penn Law community and/or the legal profession. Your statement should also include the reason you are seeking visiting status at Penn Law. Please limit your statement to two pages, double spaced. CHARACTER AND FITNESS If you answer "yes" to any of the following questions, you must attach an explanatory statement. If you do not, the processing and review of your application will be delayed. Has your academic experience ever been interrupted, after the start of a degree program, for one or more terms for any reason? (This does not include the time period between high school and college or between college and law school, etc.) Have you ever been placed on academic or disciplinary probation, issued academic or disciplinary warnings, suspended, dropped, expelled, or been required to withdraw from any post-secondary education you have attended, or are any such proceedings now pending against you? (This should include matters that have been expunged.) Have you ever, either as an adult or a juvenile, been arrested, charged, cited, or convicted of a crime (including misdemeanors), or is any charge now pending against you? (This should include matters that have been expunged or subject to a diversionary program.) VOLUNTARY PERSONAL DATA Answering the following question is optional. This information is confidential and answering the questions or the omission of an answer will not influence the Law School's decision on admission. On occasion, our students, graduates, and student organizations may ask for the names, addresses, and email addresses of admitted applicants so they can communicate with them about conferences, symposia, and other Law School events. Do we have your permission to provide this information? Do you identify as a lesbian, gay, bisexual or transgender person? Are you Hispanic or Latino?, Hispanic or Latino (including Spain) If yes to Hispanic/Latino, which best describes your ethnic background? Central America Cuba Mexico Puerto Rico South America (excluding Brazil) Spain Other Hispanic/Latino Regardless of your answer to the prior question, please check one or more of the following racial groups and subsequent background identifications (if known) for which you are a member. American Indian or Alaska Native (including all Original Peoples of the Americas) Alaska Native Chippewa Choctaw Cherokee Navajo Sioux Other American Indian Are you enrolled in a tribe?, please enter tribal enrollment number Asian (including Indian subcontinent and Philippines) China India Japan Korea Pakistan Philippines Vietnam Other East Asia Other Indian Subcontinent Other Southeast Asia Black or African American (including Africa and Caribbean) U.S. / African American Africa Caribbean Other Black Native Hawaiian or Other Pacific Islander (Original Peoples) Guam Hawaii Samoa Other Pacific Islands (excluding Philippines) White (including Middle Eastern) Europe Middle East Other White Page 4 of 5

CERTIFICATION STATEMENT By signing this application, I certify that all information I have submitted in this application and in any supporting documents of my candidacy for admission to the University of Pennsylvania Law School is complete and true. I agree to promptly notify the Office of Admissions and Financial Aid of any changes in the information I have provided in this application. I understand that providing false or misleading information or failing to provide updated information can result in a withdrawal of an offer of admission, dismissal, or other disciplinary sanctions. The Law School reserves the right to withdraw an offer of admission if the candidate fails to maintain satisfactory scholastic standing for work in progress, if final records fail to show completion of courses and/or degrees required for admission, or if the admission decision was based on incomplete or inaccurate information furnished by the applicant. Materials submitted in support of this application will be retained by the Law School and may be made available to the State Board of Bar Examiners. SIGNATURE DATE (please print) L LSAC ACCOUNT NUMBER University of Pennsylvania n-discrimination Policy and Safety Statement The University of Pennsylvania values diversity and seeks talented students, faculty and staff from diverse backgrounds. The University of Pennsylvania does not discriminate on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status or any other legally protected class status in the administration of its admissions, financial aid, educational or athletic programs, or other University-administered programs or in its employment practices. Questions or complaints regarding this policy should be directed to: Executive Director of the Office of Affirmative Action and Equal Opportunity Programs, Sansom Place East, 3600 Chestnut Street, Suite 228, Philadelphia, PA 19104-6106; or 215.898.6993 (voice) or 215.898.7803 (TDD). Specific questions concerning the accommodation of students with disabilities should be directed to the Office of Student Disabilities Services located at Stouffer Commons, Ste 300 3702 Spruce Street, Philadelphia PA 19104-6027; or 215.573.9235 (voice) or 215.746.6320 (TDD). Federal law, the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, requires all institutions of higher education to provide information on their security policies and procedures and specific statistics for criminal incidents and arrests on campus to students and employees, and to make the information and statistics available to prospective students and employees upon request. The Pennsylvania Uniform Crime Reporting Act requires Penn to provide information about its security policies and procedures to students, employees and applicants; to provide crime statistics to students and employees; and to make those statistics available to applicants and prospective employees upon request. The information about Penn is available at http://www.publicsafety.upenn.edu/clery/report/ or by calling the Division of Public Safety at 215.898.4481. Page 5 of 5