Online Application

Please complete each section of the application packet. The application itself may be completed here online. Once your application is received, we will be sending you a confirmation email and letter with additional forms to be returned to the Graduate School. You can also use our online forms.

*Important Note:
Ed.D. prospects will need to complete a special application which is not offered online. If you are interested in obtaining your Educational Doctorate, please submit an online Information Request form, and we will send you the necessary application materials.

Full Legal Name:
Preferred Name:
Social Security Number:

Permanent Address:
Street:
City: State: Zip Code:
E-mail address:
Phone Number:

Work Address:
Company Name:
Street:
City: State: Zip Code:
Phone Number:

Program:

*Important Note: Our Counseling programs are no longer accepting applications for Fall 2008. You may apply to the Fall 2009 semester on the Main Campus in Boiling Springs, NC. The preferred deadline for Fall 2009 on this campus is February 1st. We are accepting Fall 2009 applications to the Mental Health Counseling program at our Statesville Campus at this time.

I wish to apply for the term beginning:

Educators / Nurses: Current License:

Status:

The Center to which I am applying is:
Other:

(Note that not all programs are offered at every center.)

Previously enrolled in Graduate Studies at GWU (Semester and year):

Educational Background:
Please include: Institutions, Addresses, Dates Attended, Degrees Earned

Teaching / Work Experience:
Please Include: Schools / Organizations, Addresses, Grades / Subject Areas (teachers), job titles (non-teachers), Dates

Professional Organizations: (Offices held, etc.)

Professional References: (Supervisors, former professors, etc.)
Please include: Names, Positions, Addresses
1.
2.
3.

Personal Data:

(The following information is requested as statistical data for Gardner-Webb and for fulfillment of requirements of law. None of the information in this section will be evaluated for purposes of eligibility for admission.)

Date of Birth (mm/dd/yyyy format):
Gender:
I receive veteran benefits.

I am a citizen of (nation):
I am a legal resident of (city, state, county):
Ethnic Origin: Other:
Religious Preference:

Gardner-Webb admits students without regard to race, color, national origin, sex, religion, or disability.

Professional Goals:

Applicant Information:
Have you ever been convicted of a criminal offense other than a minor traffic violation?
Are there any criminal charges pending against you at this time?
Have you ever been dismissed, suspended, or placed on probation at any school?

NOTE:
If you answer "yes" to any of the last three questions, please explain the circumstances in a statement below:

Student Statement:
I certify that all information given in this application is complete and accurate. When I attend Gardner-Webb I agree to abide by the established rules and regulations of the institution.

Gardner-Webb Uni versity; Boiling Springs, North Carolina 28017 USA (704) 406-4000 Send updates, comments, and corrections to the webmaster.

Graduate School
P.O. Box 7286
Boiling Springs, NC 28017
1-800-492-GRAD