Instructions: Print this form, complete the information requested, and submit it along with the rest of your Virginia Tech Graduate School application. Please submit all forms including: Application for Assistanships, Fellowships and Departmental Placement, Graduate School Scores Information, Financial Certification Form, and Reference letters.

Virginia Tech Research and Graduate Studies Graduate School
Sandy Hall
Virginia Tech
Blacksburg, VA 24061-0325
(540)231-6691     fax: (540)231-3714

Application for Graduate Study: International Applicants

Application Number: 990-00-6376
Name: Jagannathan,
Last/Family
Subadhra
First

Middle

Suffix
Semester studies will begin:
[ ] Fall
[ ] Spring
[ ] Summer-I
[ ] Summer-II
Year: ________
Please list names that may appear on transcripts other than the name given above: _______________________________________________

Mailing Address of Applicant
Street Address: _______________________________________
City/Town: ______________________________
State/Province: _________________
Mail Code: _________________
Country: _________________
[ ] Check here if this is your official address.
Home Telephone: (____) ____ - ______
Work Telephone: (____) ____ - ______
FAX: (____) ____ - ______
email: _______________________

Study Objectives
I wish to enter Virginia Tech as a: [ ] Master's
[ ] Doctoral
[ ] Non-degree seeking student.
If applying for study at a Virginia Tech campus
other than Blacksburg, please give location:
_______________________________________
Curriculum Name:
[print curriculum list for reference]
___________________________________
Curriculum Abbreviation: ______
Area(s) or concentration: ___________________________________

Chronology of Colleges or Universities Attended
(Two official transcripts must be sent to this Graduate School)
Most recently attended Least recently attended
Institution: ___________________ ___________________ ___________________
Degree: ___________________ ___________________ ___________________
Major: ___________________ ___________________ ___________________
Grade Point Average: ___________________ ___________________ ___________________
Date Degree Received
or Expected:
___________________ ___________________ ___________________
# of Hours Completed ___________________ ___________________ ___________________

Admission Test Scores Information
GRE: ________
verbal
________
quantitative
________
analytical
GRE Subject Test: ________
subject
________
score
GMAT: ________
score
TOEFL: ________
score
________
date
________
registration number
TSE: ________
score
________
date

References
(Names, addresses, and telephone numbers of persons you have requested to write this Graduate School on your behalf):
Reference 1 Reference 2 Reference 3
Name: _____________________ _____________________ _____________________
Address: _____________________ _____________________ _____________________
_____________________ _____________________ _____________________
_____________________ _____________________ _____________________
Telephone: _____________________ _____________________ _____________________

Personal Information (optional)

Virginia Tech does not discriminate on the basis of race, sex, handicap, age, veteran status, national origin, religion, sexual orientation, or political affiliation. Individuals are not required to provide information requested in order to be considered for admission.
Sex: [ ] Female
[ ] Male
Birthdate: ______
month
______
day
______
year
Birthplace: ___________________
Country of Citizenship: ___________________ If not a US Citizen, are you a
permanent resident?
[ ] Yes
[ ] No
Ethnic Group:
(check one)
[ ] Native American or Inuit
[ ] Asian or Pacific Islander
[ ] Black
[ ] Hispanic
[ ] Caucasian

Applicant's Official Address (if different from mailing address given above)
Street Address: _______________________________________
City/Town: ______________________________
State/Province: _________________
Mail Code: _________________
Country: _________________
Telephone: _________________


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