JOHN PAUL INSTITUTE

FOR STUDIES ON MARRIAGE AND FAMILY

415 Michigan Avenue, NE · Washington, D.C. · 20017

(202) 526-3799 Fax: (202) 269-6090

information@johnpaulii,edu sdoser@johnpaulii.edu

APPLICATION FORM

 

Academic Year Applied For

q     2001

q     2002

q     2003

q     2004

q     2005

q     2006

Semester

q     Fall

q     Spring

Program of Studies

q     Masters of Theological Studies

q     Licentiate in Theological Studies

q     Special

Status

q     Full Time

q     Part Time

 

 

Last Name

 

First Name

 

Initial

 

 

Sex

q    M

q    F

Citizenship

 

Social Security #

/ /

 

Status

q    Clergy

q    Religious

q    Lay

q    Married

q    Widowed

q    Separated

 

Birth

 

 

 

Month / Day/ Yea r City State Country

 

Ethnic Background

q    Caucasian

q    African American/African

q    Asian/ Pacific Islander

q    American Indian/ Alaskan Native

q    Hispanic

 

PERMANENT HOME ADDRESS

 

 

 

 

( ) -

Street                                                                                                   City                        State Zip Code                 Phone

LOCAL (Washington) ADDRESS

 

 

 

 

Street                                                                                                   City                                 State Zip Code                

COMMUNICATIONS

( ) -

( ) -

( ) -

 

Local Phone Daytime Phone FAX Email

 

DIOCESAN CLERGY ONLY

 

 

 

 

Diocese       Bishop’s Name Address of Diocese

 

 

RELIGIOUS ONLY

 

 

 

 

Community                    Province Address of Provincial House

 

 

 

ACADEMIC HISTORY

 

Degree

Major

Institution

Location

Year

GPA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Scholarships, Fellowships, Academic Awards, Honors Received

Name

Source

Year(s)

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Extracurricular, Community and/or Special- Interest Activities

Name

Location

Dates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Graduate Record Exam (GRE)

Date taken

/ /

Verbal

 

Quantitative

 

Analytical

 

                                    MONTH / DAY / YEAR

 

If not taken within the past 5 years, date planned to take GRE

/ /

MONTH / DAY / YEAR

 

Employment History

(List all positions held since college with the most recent or current position first)

Employer

Position

Location

Dates

 

 

 

/ /

 

 

 

/ /

 

 

 

/ /

 

 

 

/ /

 

 

 

/ /

                                                                                                       MONTH / DAY / YEAR

 


REFERENCES, ESSAYS AND DOCUMENTATION

 

A.      References

 

Please ask at least two professors who have taught you recently to write letters of recommendation of your past work and present potential. These letters must be sent directly to the John Paul II Institute by the professor. Please ask the professors to compare your achievement with that of other students at your level. For our records, please fill in the following information:

 

Name of Professor

Title

Institution / Location

 

 

 

 

 

 

 

 

 

 

B.      Essays

 

¨     Essay # 1  THEME: PAST EXPERIENCES

Discuss briefly some of your past experiences which have led you to pursue a graduate degree in the area of theology and family studies:

 

¨     Essay # 2  THEME: FUTURE PLANS

In your estimation, what purpose will this education serve in your future?

 

C.      Documentation

 

The following documentation is required to complete the application process:

 

q     Official transcripts of all post-secondary education (sent by the institution)

 

q     An official copy of your High School Diploma

 

q     Official Graduate Record Exam (GRE) scores. Our institutional code is 3533.

We are listed as the Pontifical John Paul II Institute

 

q     A copy of your birth certificate or passport

 

q     A letter of permission from your Bishop or Provincial if you are a diocesan clergy or religious

 

q     Two letters of recommendation from faculty members of academic institutions formerly attended by the applicant or from employment supervisors where applicable

 

q     A non-refundable application fee of $30 in US funds must accompany this application

 

 

________________________________________________________ ____________________

Signature                                                                                                      Date

 

 

 

Non-resident Applicants

 

If you are not a U.S. citizen and are planning to enter the United States with a student VISA, the following must be completed before your application will be considered.

 

VISA number (if you currently have a VISA)             _________________________________

 

Financial Information

 

Expenses

Resources

 

 

Tuition (one year fulltime study) $ 9,500

Student’s personal funds $

Estimated fees 200

Funds from another source

Living expenses (minimum) 5,000

(Specify type and source)

 

 

Total $14,700*

Total $ *

 

* Please note that the amount of money that the applicant is planning to provide must match or exceed

the total amount of expenses calculated for one academic year.

 

 

 

Committed to the teaching of Vatican Council II that “every type of discrimination, whether social or cultural, whether based on sex, race, color, social condition, language or religion, is to be overcome and eradicated as contrary to God’s intent” (GS 29), the Pontifical John Paul II Institute admits students of any race, color and national or ethnic origin.

 

 

 

 

 

Admissions Office Use Only

 

______ Application Fee ______ Transcripts ______ GRE Scores

 

______ Recommendation #1 ______ Recommendation #2 ______ Other Recommendation

 

______ Clergy/Religious letter ______ High School Diploma ______ Birth certificate/passport

 

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