Jackson State University- Division of Graduate Studies

Application for Admission to Graduate Degree Candidacy:  Masters'


Directions:  On-line directions are found in "CyberOrientation".  Click here: Master.
Please submit three (3) copies of form (one original and two copies) to the Division of Graduate Studies.


Section 1.  To be completed by the student.  Complete the "typed" section prior to printing and obtaining the required signatures.

Name:   JSU ID No. J

Street, Apt. No.

City, State, Zip.

Home/Cell Telephone:    E-mail:    

Expected Date of Graduation:   Year:   Semester:    

1.  Degree:  Major:

2.  Graduate English Competency Examination  List Semester:     
3. Program Option Selected  Note:  The Committee may be formed at a later date.  Omit Section 2 and complete the "Committee Approval  Form".

Signature of Student/Date:  ___________________________/____




Section 2. Committee Approval:  We have read this proposal for significance, methodology, sources of data, compliance with IRB/IACUC regulations and recommend its acceptance. We agree to serve on this committee in accordance with the policies of the department/program, college, and Division of Graduate Studies.



Committee Chair/Date

Name Typed:



Committee Member/Date

Name Typed:



Committee Member/Date

Name Typed:



Committee Member/Date

Name Typed:



Section 3.  Certification and Recommendation of the Department/Program and College.

We have examined the entire graduate record of the student named above. The required grade point average (GPA) of the department/program has been maintained. The requirements of the department/program, school, college and the Division of Graduate Studies for Candidacy have been met.   (Please attach a current Degree Evaluation).)

We recommend that this student be admitted to candidacy for the degree indicated. (Please sign and date


Advisor: _____________________________/_______


Program Director: ______________________________/______


Chair: _______________________________/_____


College Dean: ______________________________/______

Section 4.  Accepted for the Graduate Council.

Graduate Dean:  ___________________________/_________


Effective: January 2008, supercedes Forms A and II.