SWELL Application Howard Payne UniversityAcademicsSchoolsSchool of EducationDepartmentsDepartment of KinesiologyMaster of Education in Sport and Wellness LeadershipSWELL Application Note: Please do not navigate away from this page before clicking "Submit." Your responses will not be saved. Fields marked with * are required. Personal Information Last Name * First Name * Middle Name Maiden Name Gender * Male Female Date of Birth * Citizenship * United States Resident Alien Non-Resident Alien Self-identified Ethnicity * African-American/Black American Indian/Alaska Native Asian/Pacific Islander/Hawaiian Native Hispanic/Latino Multi-Ethnic White Unknown Current Address * CIty * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Email Address * Phone Number * Phone Number 2 Religious Preference * Baptist Protestant, non-Baptist Catholic Islamic Jewish Hindu Buddhist Other None Employment Are you employed? * Yes No Where? * Supervisor's Name * Supervisor's Phone Number * Education Have you ever attended Howard Payne University? * Yes No Dates of attendance * Degree/Major/Minor * Please list all previous colleges/universities attended. College 1 * Location * Degree and Major/Minor * Dates of Attendance * College 2 Location Degree and Major/Minor Dates of Attendance College 3 Location Degree and Major/Minor Dates of Attendance Were you on academic or disciplinary suspension at any college or university you have attended? * Yes No Are you an international student? * Yes No Have you taken the TOEFL? * Yes No Have you requested that your test score be sent to HPU? * Yes No Academic Interests My primary interest area is * Sport Leadership Wellness Leadership Other Please explain * I will apply for a Graduate Assistantship * Yes No References Please identify two (2) references and their title and phone/e-mail contact information; both should be able to address your promise as a graduate student in Sport and Wellness Leadership. Reference 1 * Reference 2 * I authorize the references provided in this application to give any and all information concerning my character and any pertinent information they may have, personal or otherwise, and release all such parties from liability for any damage that may result from furnishing the same to Howard Payne University. * Yes No Additional Information Have you ever been convicted of, pled guilty or no contest to, or received probation, suspension, or deferred adjudication for a felony or any offense involving moral turpitude (including, but not limited to, theft, rape, murder, swindling, and indecency with a minor)? * Yes No Please state where, when and the nature of the offense. A felony conviction is not an automatic bar to admission. The university will consider the nature and date of the offense. * I understand that the university may review criminal history of applicant. This application becomes the property of the university. The university reserves the right to accept or reject this application verified & affirmation accepted. * Yes No I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent admission. * Yes No Essay Submit 500-word statement of your professional goals, how SWELL can benefit you in achieving them, and what your experiences to date may contribute to your fellow students and the program. Essay * Uploading Files. Please Wait.