Date of Birth:		/ / Month / Day / Year (eg. March 20, 1950 is 03/20/1950)
Gender:		Male Female
Marital Status:		Single Married Widowed
Are you working on a degree program at LSU?		Yes No
If yes, what is your major?
If yes, what degree?		MA Ed.S Ed.D
Are you working on a credential program at LSU?		Yes No
What is the highest degree or diploma you have earned?		Choose one High School Associate Bachelors Masters Specialist Doctorate

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Section 2: Statement of Purpose

By requesting pre-registration at La Sierra University, I intend to:

 CHECK ONE of 1, 2, or 3 below.  Also initial the corresponding statements:

1. Continue enrolling in course(s) necessary to finish the degree program for which I have already been formally accepted at La Sierra University.

2. Pursue a Master of Arts degree through La Sierra University but have not been formally accepted.

        If you checked box 2 above, please initial the statement that follows:

Based on your Statement of Purpose above, your admission status is currently designated as "Graduate Unspecified Non-Degree" pending formal acceptance.  Grad-Unspecified/Non-Degree students need to be formally accepted for a certificate, credential or degree program in order to ensure that the courses taken will count toward the desired graduate program.  A maximum of 12-quarter units may be transferred to a graduate program from an unspecified status. I have read the "unspecified policy" and understand how it applies to me    (Type in your initials to verify)

3. Take course(s) for professional development ONLY and do not intend to pursue a degree through La Sierra University..

        If you checked box 3 above, please initial the statement that follows:

Based on your Statement of Purpose above, your admission status is currently designated as "Graduate Unspecified Non-Degree" pending formal acceptance.  Grad-Unspecified/Non-Degree students need to be formally accepted for a certificate, credential or degree program in order to ensure that the courses taken will count toward the desired graduate program.  A maximum of 12-quarter units may be transferred to a graduate program from an unspecified status. I have read the "unspecified policy" and understand how it applies to me    (Type in your initials to verify)

Please read an initial the requirements for Admissions into the Master of Arts Degree Program

Master of Arts Admissions Requirements

The following items are required in order for the Admissions Office to review a file for acceptance:

  (Type in your initials to verify) I have read the "Master of Arts Admissions Requirement statement" and understand how it applies to me. 

You may visit the Admissions page at www.lasierra.edu and apply online to the University.  You may also call the admissions office at (909) 785-2176 or email at admissions@lasierra.edu and request an application packet to be mailed to you.

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Section 3: Course Selection

LSU must be notified by the first day of class if you do not plan on attending. Either you or your extended campus coordinator must contact the School of Education at lsoria@lasierra.edu or La Sierra Records office at registrar@lasierra.edu.  Any student who is registered for a class but does not attend will receive an “F” grade.

By initialing to the left, I state that I have read and understand the statement above.